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HomeMy WebLinkAboutBuilding PermitsOF . TOWN OF YARMOUTH Building Department BUILDING - . - - • • (508) 398-2231 ext.261 PERMIT NO B-04634 - PERMIT x ISSUE DATE _11/20/03. - ; PROPOSED US APPLICANT Robert Dunphy . .... . . . . .. . .. JOB WEATHER CARD ADDRESS ;541 Main Street P PERMIT TO • New Construction ; AT(LOCATIOVI) 100158MERCHANTAVE ZONING DISTRIC FR:401 Bldg. Type: Residential SUBDIVISION MAP LOT BLOC 127 24 BUILDING IS TO BE: CONST TYPE EB- USE GROUP R-4 LOT SIZE new construction: 2.5 baths, 3 bedrooms, 1 deck with roof, 1 diningroom, 1 kitchen, 1 REMARK laundryroom, 1 livingroom, 1 loft area, one two bay garage as per plans dated 11/17/03. AREA (SO FT) EST COST ($ $186,500.00 PERMIT FEE ($) OWNER I Robert Dunphy LDING DEPT BAG ADDRESS 15411 Main Street Harwich MA 02645 CONTRACTOR LICENSE 069294 Dunphy, Robert 218 Blue Rock Road South Yarmouth MA 02664 5087601318 It- r'.i Certificate Issue Date / CERITIFCATE.of._OCCUPANCY_- / Departmental Approval for Certificate of Occupancy and Compliance Inspector Date Permit Number Approved By Remarks _ BUILDING /&4'6'0 PLUMBING/GA 1,/rJ ELECTRICAL �p ENGINEERING OTHER /01 v 9--413 U� To be wiea in by each division racatea nereon upon oompieuon or as nnai urspecuon. APPROVED YARMOUTH COMMITTEE OKHRDD '15, j • F t\ R 0 LLJ cra o N ILLI �..'� - W W c" W U O Commonwsaa o/ec7*aM,.LA OfT�iciaJl/Use Only 2aparlm.ni of 5;,. &rvlca! Permit No. Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07j ieaveblank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEQ, 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORAIA TION) Date: September 10,2013 Cityor Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number)158 MERCHANT AVE O,ter or Tenant BOB OBERG Telephone No Address is permit in conjunction with a building permit? Yes ❑ No ✓❑ (Check Appropriate Box) lose of Building RESIDENTIAL Utility Authorization No. lug Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters ber of Feeders and Ampacity and Nature of Proposed Electrical Work: INSTALL SECURITY SYSTEM 3 FAX PERMIT AND PERMIT# BACK TO US AT: 508 398-5666. THANK YOU No. of Recessed Luminaires No. of Cell: Susp. (Paddle) Fans o. o ota Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires _ _.__ Swimming Pool ove ❑ n- ❑ rnd.-- rnd.-- o. o Emergency Lighting Battery Units" No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners o. of Detection an Initiatin Devices No. of Ranges No. of Air Cond. Tons No. of Alerting Devices No. of Waste Disposers eat Pump Totals: um er ons o. o e - onta ne Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ uo c pa ❑ Other Connection No. of Dryers Heating Appliances KW SecuritySystems:* Devices es or Equivalent 9 o. of Water KW Beaters o. o o. o Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP a ecommumcattons r n : No. of Devices or E uivaa ent OTHER: $725.00 nrracn aaamonat aetaa p aesuea or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) �- Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The ndersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE 0 BOND ❑ OTHER ❑ (Specify:) w I cerfiry, under the pains and penalties of perjury, that the Information on this application is true and complete 3z FIRM NAME: Cape Cod Alarm Co. Inc. LIC. NO.: 1592C p Licensee: GENE CORMIER Signature LIC. NO.: (lfapplicable, enter .,exempt " in the license number line.) Bus. Tel. No.- 08 398-6316 Address: 204 OLD TOWNHOUSE ROAD WEST YARMOUTH, MA 02673 Alt. Tel. No.: 800 468.8300 'Per M.G.L. c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lic. No. SS CO 000248 OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one El owner El owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $ 45.00 OF k TOWN OF YARMOUTH Building Department BUILDING (508) 398-2fexAPERMIT NO'8-04834pERMIT ISSUE DATE 11/20/03• - ; PROPOSED USEAPPLICANT -Robert Dunphy ................JOB WEATHER CARD ADDRESS '541 Main Street PERMIT TO ; New Construction ; ----------------- -- --' AT (LOCATION) 100158MERCHANTAVE ZONING DISTRIC R-40 Bldg. Type: Residential SUBDIVISION MAP LOT BLOC 127.24 LOT SIZE BUILDING IS TO BE: CONST TYPE 5_B USE GROUP R-4 new construction: 2.5 baths, 3 bedrooms, i deck with roof, 1 diningroom, 1 kitchen, 1 REMARK laundryroom, 1 livingroom, 1 loft area, one two bay garage as per plans dated 11/17103. AREA (SO FT) EST COST ($ $186.500.00 PERMIT FEE ($) OWNER lRobart Dunphy BUILDING DEPT BY ADDRESS 1541 Main Street Harwich MA 102M Date �7_ 3 -/z -O C/ %��166 /a-S'ov I %i nCi � � /T /j 4 l ?� 7 � INSPECTION RECORD Note Progress - Corrections and Remarks a 4 Q CONTRACTOR LICENSE 069294 Dunphy, Robert 771 218 Blue Rock Road South Yarmouth MA 02664 5087601318 ... . FIELD COPY Inspector oF'YgR,� ONE & TWO FAMILY ONLY - BUILDING PERMIT O APPLICATION TO CONSTRUCT, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING p C Town of Yarmouth Building Department �.,..�.; ,r 1146 Route 28 • Yarmouth, NIA 02664-4492 fO..-.U•i. C� Tel: (508) 398-2231 x261 •Fax: (508) 398-0836 A / tl Office Use Only Permit No 1 . to k v r / Permit Fee $ Deposit Rec'd. $ ate 0 � Net Due $ D Planning Board Information Type Endorsement Date ecording Date an No. Other Assessors Department Information: Map Lot Ma of Old New 1.4 Property Dimensions: Lot Area (sf) Frontage (ft) Lot Coverage This Section for Office Use Only Building Pe i u e Date Issued: Signature• -0-7 Certificate of Occupancy is is not required 8wl ng Official Date Section 1 - Site Information I Use Group: R-4 Type: 5-B 1.1 Property Address: 158 Merchant- Ayn- 1.2 Zoning Information: o 2oning District Proposed Use Yarmouthoort 1.3 Building Setbacks (ft) Front Yard Side Yards Rear Yard Required Provided Required I Provided Required Provided 30' 32' 15' 15.7 & 55' 20' 22' 1:4 Water Supply (M.G.L: c. 40: S 54) Public x Private 1.5 Flood Zone I ormabon: " " ' ` ' Comments: Zone: EIFE: Section 2 - Property Ownership/Authorized Agent 2.1 Owner of Record: 541 Main Street,Harwich Ma. Nam (print Mailing Address 02645 Signs r Telephone 2.2 uthorized Agent: Name (p �Mailin �dress t t re Te hone.',, J Fax `\ 1 Sectio 3 - Construction Services 3.1 Licensed Construction Supervisor: J J/" BY DTe 218 JLIjie Rock S.Ya outh Ma License Number 069294 Addres _ A ejExpiration Date Signat elephone qhrrRegister6d Home Im rovement Contractor: Company Name Not Applicable ❑ License Number Address Signature Telephone Expiration Date I" 9 - 15 - 99 1 of 2 OVER PLEASE PRINT: lob Location: TOWN OF YARMOUTH BUILDING DEPARTMENT CONSTRUCTION SUPERVISOR FORM 158 Merchant Ave. Yarmouthport Number Street Village Owner of Property: Walden Corporation/Robert B. Dunphy Construction Supervisor: Robert Dunphy 069294 760-1318 Name License No. Phone No. Address: 541 Main Street,Harwich, Mass. 02645 Licensed Designee: (If other than Supervisor) Name 2.15 Responsibility of each license holder: License No. 2.15.1 The license holder shall be fully and completely responsible for all work for which lie is supervising. He shall be responsible for seeing that all work is done pursuant to the state building code and the drawings as approved by the building official. 2.15.2 The license holder shall be responsible to supervise the construction, reconstruction, alteration, repair, removal or demolition involving the structural elements of building and structures only pursuant to the state building code and all other applicable laws of the commonwealth, even though he, the license holder, is not the permit holder but only a subcontractor or contractor to the permit holder. 2.15.3 The license holder shall immediately notify the building official in writing of the discovery of any violations which are covered by the building permit. -- — —�J 2.15.4 Anylicenseewho shall willfullyviolate subsections 2.15.1, 2.15.2 or 2.15.3 or any other section of these rules and regulations and any procedures, as amended, shall be subject to revocation or suspension of license by the board. 2.16 All building permit applications shall contain the name, signature and license number of the construction supervisor who is to supervise those persons engaged in construction, reconstruction, alteration, repair, removal of demolition as regulated by section 109.1.1 of the code and these rules and regulations. In the event that such licensee is no longer supervising said persons, the work shall immediately cease until a successor license holder is substituted on the records of the building department. 2.17 The license holder shall be responsible for requesting all required inspections. Failure to do so may be deemed a violation of the permit conditions. I have read and understand my responsibilities under the rules and regulations for licensing construction supervisors in accordance with section 109.1.1 of the state building code. I understand the construction inspection procedures and the specific inspection as called for by the building official. INSURANCE COVERAGE: I have a c rre liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.152 Yes WNo ❑ If you have fhecked yu, please indicate the type coverage by checking the appropriate box. A liability insurance policy ❑ Other type of indemnity ❑ Bond ❑ INSURANC I am aware that th licensee does not have the insurance coverage required by 2 of the Ma . Genera ws, and that m signature on this permit application waives this requirement. /2 Check one: Owner or Owner ❑ Agent ❑ Building Official Approval: S The Commonwealth of Massachusetts Department of Industrial Accidents O111c0011"Ost/MMSS 600 Washington Street Boston, Mass. 02111 �y Workers' Compensation Insurance Affidavit Applicant information: Pl ae FRiNTTrdsl,Fg namr• Dublin Construction,Inc. locninn- 158 Merchant Ave. ut% Yarmouthport 430-470 nhon to 1 am a homeowner performing all work m)self. ❑ 1 am a sole proprietor :c : hate no one workinc in any capacity p I am an employer pro% iding workers' compensation for my employees working on this job. eomnanv name' address: city phone q- Ins LLt�nce Co. nolicy W I am a sole proprietor. general contractor. or homeowner (circle one) and have hired the contractors listed below who ha%e the folluwin_ workers' .ompensation polices: company name: --- Dublin _Construction, address: 541 Main Street, city: Harwich,Mass phone q: 508-430-4700 insuranccCo. Traveler's nolicy# 6KUB-7855A70-1-03 Failure to secure coverage as required under Section 25A of MGI. 152 can lead to the imposition of criminal penalties of a Ilse up to 111,,500.00 and/or one years' Imprisonment as well as civil penalties is the form of a STOP WORK ORDER and a Bee of SIOCIA0 a day against me. I understand that a copy of this statement may be forwarded to the Omct of Investigations of the DIA for coverage veri0utloa. I do hereby ce ijy under he point andpenal ' t oj'perjD that the infor n provided above is true and e//"�et na .o� //LI�iG� / O/rl 0 Print name official use only do not write in this area to be completed by city or town oMcial city or town: YARMOUTU _ permit/license M nBuilding Department pl.lcensiog Board O check if immediate response is required 261 ❑Stltctmtn's Omct (50) 398 QHeallb Department contact person: phone N; _ 8—2231 eat. riOthtr - .Y 11 0141 BUILDING TOWN OF Y A R M O U T H ELEGrRICAL GAS 1146ROUTE28 SOUTHYARNIOUTH NIASSACHUSETTS02664-4451 Telephone (508) 398-2231, ExL 261 — Fax (508) 398-2365 PLUMBING SIGNS BUILDING DEPARTMENT DEMOLITION DEBRIS DISPOSAL AFFIDAVIT Pursuant to M.G.L. Chapter 40, Section 54 and'780 CMR, Chapter 1, Section 111.5, I hereby certify that the debris resulting from the proposed work/demolition to be conducted at 158 Merchant Ave. , Yarmouthport Work Address is to be disposed of at the following location: S&J Exco, Great Western Rd. , Dennis Said disposal site shall'be-a licensed solid waste facility as"defined"by M:G:L: Chapter 111, Section 150A. Signature of Applicant Permit No. Dad . Y_e YARMOUTH BUILDING DEPARTMENT ute 28, South Yarmouth, NIA 02664 508-398-2231 ext. 261 LOT INQUIRY FORM (used for zoning purposes only) Assessors' Map No.I Lot No. Street Endorsement Date of Subdivision Plan and Type (if applicable) Total Land Area (sq. ft.) Name of Current Inquirer's Name (if different from Inquirer's Mailing Building P- C✓i No. .Telephone No. % (iD — By signing this application I assert my understanding that the purpose of this inquiry is to determine whether the aforementioned lot(s) qualifies for prof fford a heretofore -undeveloped land and that to the best of my knowledge this lot(s) has never previously beencuilt:; Signature of Applicant Date of Inquiry (for office use only) Does not conform to the applicable provisions of M.G.L. Chapter 40A, Section 6, Definitive Plan Exemption and/or the applicable zoning bylaw, as per the information provided on this date. Reason Conforms to the applicable provisions of M.G.L. Chapter 40A, Section 6, gOor �ectio 043.4, ara. S of the zoni g bylaw as per the information provided on 1his date. C mments: Protected pursuant to the applicable provisions of M.G.L. Chapter 40A, Section 6, Defuutive Plan Exemption. Application is incomplete. Comments: Adequate road access must be present. A determination of adequate access shall be made by the Planning Board pursuant to M.G.L. Chapter 41 prior to the issuance of a building permit. (if applicable.) Shall satisfy Title V requirements. (See Health Dept.) V Shall satisfy Conservation regulations, if applicable. ✓ Shall satisfy the 07 Highway Regional Historic District Commission (if applicable) Investigator's Signature Date '1;Z6 Rev. 8/02 LOT T45 OC400164 MERCHANT AVE BOOK D�o 1 •- , ... y ACCT41 127.23 MAP 114 LOT T29 Mai LOC 00150 MERCHANT AVE Pi DOC. CSRT."PROBATii: ACCT# 1 25 AP 114 LOT T45 LQC 0016*- CHANT AVE owe, DOG:'.• _ C[RT. :'rROBATt '_DATt -7777 P. 6 ml FZ�AWA F A 12, / ACCT 1227.23 MAP 114 LOT T29 LOC O1`5#-MERCHANT AVE Plan Sls ,DOG C[RL PROBATt - :. .• - 7d ,. I ... � „Plan 75'/ � �' //Ilts •,,.✓ LCT# 127.24 MAP 114 LOT T27 OC 00158 ME CHANT AVE P�aD -7Y/ - -.. DOC. ,. CERT. PROBATE a YO It ' • ..:a -.tdlk,.u.k'�'5.. � , r'r.j„ �tn.�,K: A .. u,,. a'. ., a.."`Mtr�7'arks w;� � . r • �'� B1,C1 1444 PG313 T .LpO� v 05-22-19913 C u� r 12 ��`:1✓ 4 THE EVELYN YO.NKER.S7'RUST • ,� OQ \` > TRUSTEES' CERTIFICATE \<::o a Lndersigned. EVELYN YONh'FRS of 46 Merchant Avenue, YurrnouQtperi, h 'chus:tts and LOLA ABT of Hoffman Estates, Illinois, the Ttu�fces of 7"Ilk, EVELYN VONKERS TI:UST, under Declaration of Trust dated August 15, I985, recorded with B utukblc County Registry of Deeds in Rook 4670, Pagc 8, ("Trust") herebyceriifies as follows: (1) The 7-rusk is now in full fomc and effect and has not been amended or modified, except (1) Pu»uant to on Am6-ndmcnt dated March 10, 1995, the specifics of which are eon:aincd in a Trusu%c`s Certificate dated ldarch 10, 1995 and recorded at the Barnstable County Registry of Dceds at Roo: 9595, Page 167 and (ir) as specified below. (2) Wc.we the sole duly appointed Trustees of the Trust and have neitlier resigned no, ix en removed its Trustee. (3) 01) the cightecnth day ol'May, 1998, THE EVELYN YONKERS TRUST was wncndcd b) at itts•.runtent in writing signed by the holders of at least seventy -live (75%) fcrce;nt of the total beneficial interest in the Trust, (4) The terms of the aforesaid Amendment are as follows; LOLA ART of Hoffman Estates, I)lino14 was thereby appointed an addiilonal Trustte of sald Trust. {S} !u t»1l alter respects the provisiors of THE EVELYN YONKERS TRUST were ratified w,d at tinned; and (61-1 h: aforesaid Amendment has bean filed with us on the eightccni)t day of Njay, 1998. L:xecuted under seal this eighteenth day of May, I998. .r EV LLIW 'Oh LOLA ABT COMMONWEALTH OF MASSACHUSETTS ><tll)1)1.F5f:X: �S. May l8; 1998 Thca perbonally appeared the above named EVELYN YONKERS ar4 Tnsteas as aforesaid, and acknowledged the foregoing 1obethcer eact Qj. ...... . J�. DUNNIIELL — NOT — My commission expires: 0 -08 •' .,..::= ., r •• iv (1 t 7..•,�. BARNSTABLE REGISTRY OF DEEDS --- •-- ____ r.. �L T1Iii EV1iLYN 1 ONKERS tJTRUST1-1039 10 :24 xjtUSTEE'S CEItTtt try The undersigned L' V ELYN YONKERS now of Naplcs, Flo. ida and LOLA A13T now of Nuples, Florida, the Trustees of THE EVELYN YONKERS TRUST, under Declaration of Trust dated August 15, 1985, recorded with Barnstable County Registry of Dads in (look 4670, Page S. ("Trust') hereby ccrti fy as follows: 1. The Trust is now in full force and effect and has not been amended or modified, except pursuant to an Amendment dated March 10, 1995, the specifics of which are contained in a 'trustee's Ceniticate dated March 10, 1995 tmd recorded at the Bzrnstable County Registry of Uecds at Bock 9595, Page 167 a,ld an amendment dated May IS, 1998, with a Certificate rccordcd in hook 11444, Page 313, and as specified below. 2. We wcte the sole duly appointed Trustees of the Trust and Evelyn Yonkers is now resigning as Trustee and Lola Abt will henceforth be the sole TftlStee by an wnendmcnt is vrifti; to said trust signed by holders of at least 75 percent of the total beneficial interest in the trust. 3. In all other respects the provisions of THE EVEL.YN YONKERS TRUS1. acre ratified end affirmed. L•accuted under seal this �.I_ day of July, 1999, Evelyn Yon',:efe— Lola AN STATE: OF rLORIDA COUNTY OF COLLIER On this day before me appeared the above named Evelyn Yonkers and Lola Abl, to me Personalty known, and acknowledged the foregoing to be their free act artd deed before me and did tAc on oath a -,is ZLI-- day ofJuly, 1999. W Notary Public �. .•, . OMIIEc 0. f Eed t ;�.xx 3 ° i1ei' �� "• �r i Printed Name of Notary �..`ti$ ls✓,�e�Ar�FatiyP�ie!►4rmrn My Conunission Expires: BARNSTABLE REGISTRY OF DEEDS ..v..r a 11 TOWN OF YARMOUTH Building Department Town Hall Yarmouth, MA 02664 (508) 398-2231 64261 BBUILDING PERMIT APPLICATION RECEIPT Temp Permit No.: T-04-217 Applicant Name: Robert Dunphy Location: 00158 MERCHANT AVE Owner's Name: Owner's Addres Robert Dunphy 541 Main Street Harwich MA 02645 Owner's Telephone: (781) 718-0881 (OFFICE USE ONLY Recorded By. Ic Permit Fee: $0.00 Deposit Rec: $50.00 Payment Type: Check ChkNo.: 7428 Net Owed: ($50.00) Application Date: 10/22/03 Issue Date: Expiration Date Comments: new construction: ZONING APPROVED z9L��/i,f� This is NOT a building permit. Application subject to plan review. Contact Building Department for permit status. Official Building Permit will be issued upon plan review completion, approval, and complete payment of Net Owed on Permit Fee. Date Printed: 11/4/03 TOWN -OP YARMOUTH BUILDING DEPARTMENT BUILDING PERMIT APPLICATION DEPARTMENTAL TRANSMITTAL SHEET Building Site Location: No: Proposed Improvement: 7 J ,) . ry+ , i'^ •n r J►_I V LE GN,OEFO j 2003 I I.tit No: Ce�o Date Filed: /U 7 The Building Department will be responsible for assisting the applicant by dispatching your plans and or application to the following applicable departments. RESIDENTIAL AND/OR COMMERCIAL BUILDING WATER DEPARTMENT: Determines Compliance of Water Availability and or existing location ENGINEERING DEPARTMENT: Determines Compliance for Parking and Drainage. CONSERVATION COMMISSION: Determines Compliance to Wetlands Acts; i.e., If Lot(s) Border any Type of Wetlands, Streams, Ponds, Rivers, Oceans, Bogs, Bays, Marshland, Etc HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e., Requirements For Septage Disposal and other Public Health Activities. FIRE DEPARTMENT: Determines Compliance to State and Town Requirements for Personal .................................................................... Safety, Property Protection; i.e., Smoke Detectors, Sprinkler Systems, Etc. ........................ .......................................................... REVIEWED BY: 1/1. WATER DEPARTMENT DATE4Va N/A ✓2. ENGINEERING DEPARTMENT: DATE: N/A: Vf CONSERVATION: DATE: N/A V 4. HEALTH DEPARTMENT DATE: N/A: INDUSTRIAL AND/OR COMMERCIAL PERMITS S. WIRING INSPECTOR DATE: N/A: 6. PLUMBING INSPECTOR: DATE: N/A: 7. FIRE DEPARTMENT. DATE: N/A PLEASE NOTE COMMENTS: n RECEIPT OF COPY: SIGNATURE OF APPLICANT: DATE: l - 0 3 �"P�-( u -tom Whitccopy -BuMmsDepL - PiokaW -W9wDcpL - YdlowCopy -HaLMDepL . Copy -Enginc�DcpL - GoWmmd-FkcDgWCon9wvAim ...Aw"0R 4. .- .'kf�- rl, f •. - .... ♦r' 11140 v.�ivVv"�,',/L}f� r. 'J• �► "•L YOI'YY..WW'!1�'.►wrRwr+. n. '�'11 TOWN OF YARMOUTH 3� c BUILDING DEPARTMENT - `�, *-.-K• s r BUILDING PERMIT APPLICATION DEPARTMENTAL SIGN OFF F TRANSMITTAL SHEET Building Site Location: No: Ia % Lot No: 6� Y Proposed Improvement�:2 0 ia) //��l T Address: � /,p 9r 1 "S � I.No.: 760 /3 /9 Date FiledIf : The Building Department will be responsible for assisting the applicant by dispatching your plans and or application to the following applicable departments. RESIDENTIAL AND/OR COMMERCIAL BUILDING WATER DEPARTMENT: ENGINEERING DEPARTMENT: CONSERVATION COMMISSION HEALTH DEPARTMENT: FIRE DEPARTMENT: REVIEWED BY: Determines Compliance of Water Availability and or existing location. Determines Compliance for Parking and Drainage. Determines Compliance to Wetlands Acts; i.e., If Lot(s) Border any Type of Wetlands, Streams, Ponds, Rivers, Oceans, Bogs, Bays, Marshland, Etc Determines Compliance to State and Town Regulations; i.e., Requirements For Septage Disposal and other Public Health Activities. Determines Compliance to State and Town Requirements for Personal Safety, Property Protection; i.e., Smoke Detectors, Sprinkler Systems, Etc. V1. WATER DEPARTMENT: DATE: N/A: ✓2. ENGINEERING DEPARTMENT: DATE: N/A: _ P�i. CONSERVATION: DATE: N/A: 4. HEALTH DEPARTMENT: �4 �/��tl� DATE:// -/1 93 N/A INDUSTRIAL AND/OR COMMERCIAL PERMIT'S 5. WIRING INSPECTOR: DATE: N/A: 6. PLUMBING INSPECTOR: DATE: N/A 7. FIRE DEPARTMENT. DATE: N/A: _ PLEASE NOTE COMMENTS: - Ekrs�rrtrr Tiff, lI-Aw111 PKa-- P e4 /Z - RECEIPT OF COPY: SIGNATURE OF APPLICANT: DATE: / 1 —10- O 3 WhitemPr•Bud&VDcpL- Pick copy-WaurDept - YeWwCopy•HalthDepL - h&Qpy-Eogmai%Dept - GoUcamd- Fat Dcoram rmm C O H Building Site Location: Address: TOWN -OF YARMOUTH BUILDING DEPARTMENT BUILDING PERMIT APPLICATION DEPARTMENTAL SIGN OFF TRANSMITTAL SHEET No: Id 7 Lot No: 0 13 1 Date Filed: The Building Department will be responsible for assisting the applicant by dispatching your plans and or application to the following applicable departments. RESIDENTIAL AND/OR COMMERCIAL BUILDING WATER DEPARTMENT: Determines Compliance of Water Availability and or existing location. ENGINEERING DEPARTMENT: Determines Compliance for Parking and Drainage. CONSERVATION COMMISSION: Determines Compliance to Wetlands Acts; i.e., If Lot(s) Border any Type of Wetlands, Streams, Ponds, Rivers, Oceans, Bogs, Bays, Marshland, Etc HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e., Requirements For Septage Disposal and other Public Health Activities. FIRE DEPARTMENT: Determines Compliance to State and Town Requirements for Personal Safety, Property Protection; i.e., Smoke Detectors, Sprinkler Systems, Etc. •..................................•-----..........----..............................---.....................................................-------- REVIEWED BY: /1. WATER DEPARTMENT: DATE: N/A 12. ENGINEERING CONSERVATION. 4. HEALTH DEPARTMENT: DATE: N/A: S. WIRING INSPECTOR DATE: N/A: 6. PLUMBING INSPECTOR DATE: N/A 7. FIRE DEPARTMENT: DATE: N/A COMMENTS: RECEIPT OF COPY: SIGNATURE OF APPLICANT: DATE: White copy - BuDdms DepL - Pick copy - Watcr Dam - Ydbw Copy - Haft DcpL - PMk Copy -F s Dc �Goldmrod-F im Dep! a. In+tka 1 MAP/LOT_M---Z4 ADDRESS._L5$_MEP-Ckaur-:AvF-. PLAN INFORMATION PLAN TYPE. --A. M. R-'------------------------ ENDORSEMENT DATE .__� O //_2 S II_6 ____ RECORDING DATE ALQT._ L-kc-a ASSESSORS PLAN # .-141 c'------------------- PLANNING BRD. # - z 2 3 4 _.l _fZ.-_------ PLAN. BRD. RELEASE.-8_l3-1{-8,3__,gs__car 27 om RB.* 15-49 ,o4'YAR,S 0 C O y Building Site Location: Address: TOWN OF YARMOUTH BUILDING DEPARTMENT BUILDING PERMIT APPLICATION DEPARTMENTAL SIGN OFF TRANSMITTAL SHEET C�/ No: /a 7 Lot No: 6 13 1 Date Filed: The Building Department will be responsible for assisting the applicant by dispatching your plans and or application to the following applicable departments. WATER DEPARTMENT: ENGINEERING DEPARTMENT: CONSERVATION COMMISSION: HEALTH DEPARTMENT: , FIRE DEPARTMENT: Determines Compliance of Water Availability and or existing location. Determines Compliance for Parking and Drainage. Determines Compliance to Wetlands Acts; i.e., If Lots) Border any Type of Wetlands, Streams, Ponds, Rivers, Oceans, Bogs, Bays, Marshland, Etc Determines Compliance to State and Town Regulations; i.e., Requirements For Septage Disposal and other Public Health Activities. Determines Compliance to State and Town Requirements for Personal Safety, Property Protection; i.e., Smoke Detectors, Sprinkler Systems, Etc. .. ...... ... ...................................................................................................... _................................... REVIEWED BY: /1. WATER DEPARTMENT: N/A: Vf CONSERVATION: DATE: N/A: HEALTH DEPARTMENT: DATE: N/A: 71ML.. .1 1I d �u : u Y_LJN 3. WIRING INSPECTOR DATE: N/A: 6. PLUMBING INSPECTOR: DATE: N/A: 7. FIRE DEPARTMENT: DATE: N/A: COMMENTS: RECEIPT OF COPY: SiGNAIVRE OF APPLICANT: M DATE: copy - Baddmg Dept - Pict copy -water Dept - Ydlow Copy -Heah6 DepL - Pict Copy -Eo&ocq I)cpt-':? Goid=W - Fue DqL Conwva6= . r— PROPERTY ADDRESS: /�8 _ dle ALCULATION FOR PER COST TYPE OF ROOM mie� s Y+si�m lot r /a/)/,d 8 a46V ADDITION ALTERATIONS BATH BEDROOM 576 SSS� ^ CERTIFICATE OF OCCL COMPUTER ROOM 33© F'Z .,So DECK OPEN DECK WITH ROOF A j0 DEMOLITION DEN DINING ROOM FAMILY ROO M __-' FIREPLACE..__.__..-._---- % c{ g FOUNDATION ONLY Avo GARAGE NO. OF BAYS I GREAT ROOM q`6 KITCHEN LAUNDRY ROOM MUD ROOM OFFICE . PORCH CLOSED PORCH OPEN REROOFING SHED STORAGE AREA SUN ROOM HEATED SUN ROOM UNHEATED SWIMMING POOL ABOVE GRO SWIMMING POOL INGROUND WINDOW REPLACEMENT NO p� TOWN OF YARMOUTH WATER DEPARTMENT 99 Buck Island Road West Yarmouth, MA 02673 Telephone: (508) 771-7921 • Fax: (508) 771-7998 Date of Issue : Nov 6, 2003 Letter of Water Availability 1. Single Family Dwelling X 2. Duplex Family Dwelling 3. Condominium Dwelling 4. Commercial / Industrial 5. Other (Specify) Reference; Massachusetts General Laws Chapter 40, Section 54 To : Town of Yarmouth Building Inspector Please be advised that the Town of Yarmouth Public water supply is available to service lot/parcel(s) 24 Street 158 Merchant Ave. as shown on Assessors sheet/map # 127 Issuance of this Letter of Availability is subject to the following provisions/restrictions. (1) The property owner agrees to comply with all Federal, State, and Local Laws, Rules and Regulations as they pertain to the use of the Public water Supply. (2) The Yarmouth Water Department_ shall have exclusive rights_a_s to-the-size,--number;-type and location of all water service lines, fire service lines or appurtenant items connected to the water distribution system. (3) The Yarmouth Water Department reserves the right to require, at the property owners expense, the installation of water mains and appurtenant items to meet water demand requisites within any structure relevant to this Letter of Availability. (4) This Letter of Availability will expire 180 days from the date of issue. I have read and understand the provisions/restrictions of this Letter of Water Availability. Owner (Sign) Reference : Robert Dunphy : 218 Blue Rock Rd. : S. Yarmouth, MA 02664 TOWN OF YARMOUTH BUILDING DEPARTi�NT PLAN REVIEW & BUILDING PERMIT APPLICATION REVIEW NOTES. ADDRESS: Map Lot: Date of InitialReview- //—/'r ' 03 .. Approval Dale: Inspector. JSLk NOTES: ; Section 104.3.2, para. Change, lxtenson or Alteration (lxe-edstin& nonconforming) The 7,opmud regmm a Special Permit from the Z =g Board ofAppeals. Other •t Att�g Code Denial (ifapplicable) Tp... TT -Al SAN • °'" '", 0"; MOUTH Old Icing's Highway Regional I-iistoric District Committee Yir;.{-� ` 0 in the Town of Yarmouth for a TOWN CLERK CERTIFICATE OF APPROPRIATENE 2M AUG 28 API 9- 38 Application is hereby made in triplicate, for the issuance of a Certificate of APProPt tart s 4� eIS n of Chapter 470, Acts and Resolves of Massachusetts, 1973, for proposed work as described below and on plans, drawings or photographs accompanying this application for. CHECK CATEGORIES THAT APPLY: 1. Exterior Building Constru on: : Ne Building 13 Addition M Alteration Indicate type of Ho Q iazagje El Commercial 0 Other 2. Exterior Painting: 3. Signs or Billboards: Q Nc%v Sign C) Existing Sign 13 Repainting existing sign 4. Stnuture: p Fence p Wall 17 Flagpole 0 Other TYPE OR PRINT LEGIBLY DATE 8 / 7 / 0 3 ADDRESS OF PROPOSED WORK 158 Merchant Ave, ASSESSORS MAP NO. 127 OWNER Walden Corp/Robert Dunphy ASSESSORS LOT NO. 24 HOME ADDRESS 218 Blue Rock Rd. ; S. Yarmouth TELEPHONE NO. 760-1318 AGENT OR CONTRACTOR Robert Dunphy TELEPHONE NO 760-1318 ADDRESS ( Same) — -- — - ---- - - - — USE ATTACHED SHEET IN PACKET FOR ABUTTING OWNERS DETAILED DESCR► vn0N OF PROPOSED. WORK: Give all particulars of work to be done including materials to }: be used. In case of signs, give locations of existing signs and proposed locations of new signs. (Attach additional sheet, if Y necessary). I pPFF.G'� ED Y1,h�,0UTH CUt.1i;,ITiE Received by OKHC Date,-�-[) Check # ► 5Q By vC`� APPROVED DISAPPROVED is 710 13 IlUORTAN . If Certificate is approved, approval is subject to the 10 day appeal period provided in the Act. E3 Please return to: Yarmouth OKHC District Committee Yarmouth To am Hall, 1146 Route 28, S. Yarmouth, MA 02664 TOWN H I t,I`FRK 1146 ROUTE 28 SOUTH YARMOUTH MASSACHUSETTS 02664-4451 Telephone (508) 398-2231, En 292 — Fax (50 9963(28 fM 9 V OLD KING'S HIGHWAY REGIONAL HISTORIC DISTRICT COMMITTEE RECEIVED STATEMENT OF UNDERSTANDING As property owner/contractor/agent for construction at: 158 Merchant Avenue, Map #127 Lot #24 CIA W-A178 approved on 8/27/03 In accordance with the Guidelines to the Act, "Sec. E.1., only minor changes may be approved by the Committee without the filing of a new application and a new hearing. Minor changes or alterations would include such r matters as altering a single window or door change or a minor change of colors which could be made without a detrimental impact to the overall appearance of the project. All alterations by amendment or otherwise will require the local Committee's approval.° Before or after work has begun on a project approved by the:Old King's Highway ---- Committee, a request fora minor change must be submitted.to the committee in writing. Approval shall be obtained before incorporating the.change into the project. For more than one revision to previously approved plans, anew Certificate of Appropriateness must be filed and approval voted by the committee before incorporating the changes into the project. Failure to do so,will result in the Building Department issuing a Stop Work Order or delaying issuance of an Occupancy Permit or final inspection approval. Filing a Certificate of Appropriateness for revised plans, after work on the changes has been started or completed, will also result in having to pay a filing fee of $50.00. have r —J — —A _.—J___a_—J aL_ _L__-_ _1_i_____l_ Date: Signed I 3 Printed on Recycled Paper AMENDMENTS DATE C/A # s A / �7 ADDRESS I S 2 rc A G %A+ A 0 -F I. ,Tt-ve dirt 2. 3. 4. I agree to the Owner/Ag nt Signature / Coet- clGY'aJe. q T co n; - �z v w � w SPECIFICATION SHEET (YARMOUTH OKHC) Please fill out the -form in its entirety providing color ch ffiZ"*here I ERK necessary. INDICATE LANDSCAPING, EXTERIOR LIGHTING & ELECTRI ETER ON SITE PLANSFORNEWHOUSES. 1M3 °tUG Zi 111 to: 39 ADDRESS: 158 M-eYGV-14 A u P_ , FOUNDATION (18" MAX. EXPOSED): �i� THER DRIVEWAY: WALKWAY: STEPS (INDICA BRICK/ MENT/OTHER): SIDING TYPE & MATERIAL: R ed Ce ar- �` Uard - �rof& Wki{G Ce �lcs --5i.Aek fr�r FACED CHIMNEY (INDICATE BRICK/STUCCO OOACED ROOF MATERIAL: PITCH EXP. I�)IN.) MAXWINDOWS (GRILLES REQUIRED)—(WOOD/OTHER) _ INDICATE SIZES IF NOT LISTED ON ELEVATIONS: AMt sen +iltw&sH )l5clis vrpl" DOORS (WOOD/OTHER) (INDICATE SIZES AND STYLE IF NOT LISTED ON ELEVATIONS): SteeA Si* panel i- �s �t-e'en UgNk TRIM: (ALL WINDOWS & DOORS TRDX%4ED WITH IX4 / 1X5) RECL-iVE:D COLOR- OnFc,om�er� n tj COLR. COLOR: W,g�i k erL14 COLOR: ag(een COLOR: -_MATERIAL MATERIAL OF TRIM: �OOD,ALUMMM SHUTTERS ( OOD ) ANAi_Fn LIVERED) COLOR (�feP-V1 GUTTERS (WOOD/�' -- -- COLOR: GARAGE DOORS: SIZE & STYLE: S�EP.� �� S Pal COLOR: STORM WINDOWS & DOORS: C (INDICATE STIES IF NOT LISTED ON ELVATIONS) SKYLIGHTS: TYPE/SUE: C WOOD DECK: SIZE: Q,'` /�� GyDE C WOOD FENCING (MAX HEIGHT 61: STYLE: C (SHOW LAYOUT & RUNNING FOOTAGE ON SITE PLAN) &tuntgc;,.cry White HG33 RETAINING Wj (SHOW LAYOUT & SIGNS: (indicate si SIGN POST: (ind ADDITIONAL INFORMATION: REV. 12/02 Permit Number MECeheck Compliance Report Massachusetts Energy Code MECcheck Software Version 3.2 Release I a Clocked By/Date TITLE: DUBI N CONST. CITY; Yarmouth STATE: Massachusetts HDD: 6053 CONSTRUCTION TYPE: l or 2 Family, Detached IMATINO SYSTEM TTQB:Other (Non -Electric Resistance) DATE: 10 /.16 / 0 3 DATE OF PLANS: 8 / 7 / 0 3 PROJECTINFORMATION. 158 Merchant Ave. COMPANY INFORMATION: M.A.P. INSULATION CO. COMPLIANCE: Passes Maximum UA - 407 Your Home = 365 10.3%Better Than Code ___.___ ---_ -------------- ----._------__-_---_.___—Gross Glazing Arta or Cavity Cont. or Door Perimett i Value R•ViOue U-Factor Ceiling 1: Fiat Celkug or Scissor Truss 1270 30.0 0.0 44 Wall 1: Wood Frame,160 o.e. 2490 13.0 0.0 196 Window 1: Vinyl Prams, Double Pane with Low•E 200 0.340 6g Door 1: Solid 20 0.340 7 Floor 1: All -Wood Ju'strfruss, Over Unconditioned Space 1270 19.0 0.0 60 COMPLIANCE STATEMENT- The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted t6ith the permit application. The proposed building has been designed to meet the Massachusetts Energy Code requirements in MECcheek Version 3.2 Release Is. The heating load for this building, and the cooling load if appropriate, has been determined cuing the applicable Standard Design Cowfi ound in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125% Itbo dcsi 1 s�pee4f in Sections 7S 1310 and J4.4. BL'ilder/Deslgner_ Date MECcheck Inspection Checklist Massachusetts Energy Code MECchect Soilwars Version 3.2 Release la TITLE: DUBLIN CONST. Bldg. Dept. Use J Callings: ( J [ I. Ceiling 1: Flu Cciling or Scissor Truss, R•30.0 cavity insulation Conunents. _ t J Above -Grade Walls: [ J [ 1. Wall 1: Wood Flame, 16" o.e., R•13.0 cavity insulation [ Commend: J Windows: ( ] I I. Window 1: Vinyl Frame, Double Pane with Low-E, U-Wor. 0.340 I For windows without labeled U•faetom describe features: [ err Pancs Frame Ty po Thermal Break? ( J Yes ( J No J Comments: J Doors: ( ] i 1. Door 1: Solid, U-factor. 0 340 I Comments: - hors:—.— -------�--�—.-----—�--__-__.._ ---- ------ -----_--__ - [ J J 1. Floor 1: Ali -Wood Joist/rross Ova Unconditioned Sparc, R-19.0 cavity insulation J Comments: I Air Leakage: ( J I Joints, penetrations, and all other sued openings in the building envelope that are sources of air J leakage must be sealed. ( [ J Wben installed in the building envelope, recessed lighting fixtures shall meet one of the following requirements: 1. Type IC rated, manufactured with no penetradons between the inside of the recessed fixture i and ceiling cavity and sealed or gasketcd to prevent air )eakage into the unconditioned space. j 2. Type IC rated, in accordance with Standard ASTM E 283, with no more than 2.0 c fm (0.944 I Lb) air movement from the the conditioned space to the ceiling cavity. The lighting fixture. J shall have been tested at 75 PA or 1.57 lbs1R2 pressure difference and shall be labeled. i J Vapor Retarder: [ J I Required vie the wamrin-winter side of all non•verucd hated ceilings, walls, and floors. [ Materials identification: [ ] i Materials a d equipment must be Identified so that compliance can be determined. [ J I Marufactutt r muuab for all tostallcd heating and cooling equipment and service: water heating J equipment nrtat be provided. ( J i insulation R- mlua and gluing U-values most be clearly marktd on the building plans or speeiricatious. Duct lnsulatl-rht Ducts shall be insulated per Table MA.7.1. Duct Con%truction: All accessible joints, leans, and connections of supply and rtourn ductwork located outside conditioned space, including stud bays cr joist oavities/spaees wed to transport air, shall be scaled using mastic and fibrous backing tape Installed according to the to nufaawc es installation instructions. Mesh tape may be omitted whete gaps are less than lio inch. Duct tape is not permitted. The HVAC system east provide a means for balancing air and water systems. Temperature Controls: Thermostats are required for each separate HVAC system A m.,nual or autos satic mcams to partially restrict or shut off the heating and/or cooling input to each zone or flow. shall be provided Heating and Cooling Equipment Siring: Rated output appeity ofthe heatirtg/eool►ng system is Dot greats than 125%of the design load as specified in Sections 780CMR 13 10 and J4.4. ( Circulating Hot Water Systems: ] j Insulate circursting hot water pipes to the levels in Table 1. Swituming Pools: ( 1 All heated swimming pools must have an on/off heater switch anc require ■ cover unless over 20% orthe heating energy is ftomnon-depleable sources. Pool pump: mqu4c a time clock. ( Heating and Cooling Piping Insulation: ( J j HVAC piping conveying fluids above 120 °F or chilled fluids below SS °F nuut be insulated to dw j levels in Table 2. V 1I 1.I. LVVV v.I. �� vv.rvvvw..r Tablt 1: Afthnum dnsuladle 21MJckaw for Circulating Hot Waur.Poes. lwulst on Thies is in Inches by Pine Sl Heated Watct Non -Circulate rt RMu+. Circulating Mains and Runppts Tc==tute ( Fl u to o V Up to1,25" Dyer 2" 170-190 0.5 1.0 1.5 2.0 140-160 0.5 0.5 I.0 1.5 100.130 0.5 0.5 0.5 1.0 Tablet: hfWmueslnu+iarlon rblehnasforHVACPipa Fluid Temp, tn.�tarh,n n:�`�Sy1::b:�robtVirTrm Piping System Tees Rangt j) 1" and Less 4" t " 2. " to 41 Heating Systems Low PresuurcIrcmperatwe 201-250 1.0 1.5 1.3 2.0 Low TenVajiuue 120-200 0.5 1.0 1.0 13 Steam Condcns4W (for feed water) Any Lo 1.0 1.5 2.0 Cooling Systems Chilled Water, RefrigemM 40-55 0.5 0.5 0.75 1.0 and Brine Below40 Lo 1.0 1.5 1.5 NOTES TO FIELD (Building Department Use Only) a Description / Application.- • All models design certified by ETL and ETLc testing laboratories to be in compliance with United States and Canadian Safety Standards. • Completely assembled, factory tested furnace, for heating or combination heating / cooling application. • For utility room, closet, alcove, basement or attic application. • All models can be common vented with a water heater using B-1 vent. • Capable of multiple position installation - upflow, downflow or horizontal (left side and right side application). • This product must not be horizontally vented without the use of optional equipment SVB-80, Sidewall Venting Blower. Construction • Heavy gauge, reinforced, wrap -around insulated, Multi -Position Induced Draft ntlis7k Gas Furnace GMP Series p k naa r EL lZW ELMM � � 71 Ns as Ns ois EFFICIENCY RATING CERTIFIED ama Standard Equipment • Energy saving PSC, multi -speed, direct drive blower motors. • Quiet operating, sound isolated blower assembly. • 40va transformer for heating and air conditioning control service. • Combination redundant gas valve and regulator. • Integrated furnace control with diagnostics. • Blower door safety switch. • Energy saving hot surface ignition system. • Alternate bottom, left or right side return air connection provision. • Quiet operating vent motor. • Easily removable base plate. • Multiple flame roll -out switches. • Outlet air limit switch. • Pressure switch for proof of air. • Complies with California LoNox Standards. steel cabinet with durable baked enamel finish. Optional Equipment • Aluminized steel heat exchanger cells featuring our • L.P. conversion kit (LPM-01) 'weld free' manufacturing process. • Combustible floor base for downflow configuration • Aluminized steel in -shot bumers. (SBM). • Right hand or left hand connection for gas • Sidewall Venting Blower (SVB-80) for horizontal and electric service. venting. Goodman Manufacturing Company, L.P. SS-186D 1501 Seamist Houstonjexas 77008 GMP Series 4/98 PERFORMANCE RATINGS Model No. _GMP050-3 NAT GAS Input*+ BTUH Heating Capacity BTUH DOE** AFUE Temp. Rise Range 45,000 36 000 80.0 25-55 GMP075-3 75,000 60,000 80.0 35-65 GMP075-4 75,000 60,000 80.0 25-55 GMP100-3 100.000 80,000 80.0 45-75 5-65 GMP100-5 100 000 80 000 80.0n3565 GMP125-4 125,000 100,000 80.0 GMP125-5 125,000 100,000 80.0 GMP150-5 140,000 112,000 80.0 For altitudes above 2,000 feet reduce input rating 4% for each 1,000 feet above sea level. •' DOE AFUE Is based upon Isolated Combustion System (ICS). +L.P. 20m/cell NORMAL INPUT BEFORE PURCHASING THIS APPLIANCE, READ IMPORTANT ENERGY COST AND EFFICIENCY INFORMATION AVAILABLE FROM YOUR RETAILER. SPECIFICATION DATA Flertriral rharartaristirs 115/t/rn r4nc Cnrvirn r-nnnnrri.... t M• VDT Model MP RLQWFR Vent Dia . Filter.. Size In Electrical Ship Wt. ' Motor . DiaidthJ W FLA Max HP Speeds Metal 050-3 1 /3 4 10 6 1 4 14 X 25 5.2 15 114 075-3 1 /3 4 10 6 4 14 X 25 5.2 15 124 075-4 1 /2 3 10 8 4 16 X 25 7.8 15 136 100-3 1/3 4 10 8 4 16 X 25 5.2 15 146 100-4 1 /2 3 10 8 4 16 X 25 7.8 15 146 100-5 3/4 3 11 10 4 20 X 25 8.2 15 156 2 10 4 20 X 25 7.8 15 - - --166 -_- 125-5 314 3 11 10 4 20 X 25 8.2 15 166 150-5 3/4 3 10 6 2 4••• 24 X 25 9.6 15 176 rmur dimensions Tor bottom application. Ali moaeis require lu- x 2b- viter(s) Tor side air installations. Permanent air fillers recommended. Both sides or bottom inlet(s) must be used for applications over 1800 c.f.m. •••GMP150-5 requires 5' diameter vent in downflow configuration. DIMENSIONS o- A 3i'r . a/r (nr) Clearances for Combustible Material (all models) Sides Rear Top Front• Vent Vert I Horiz Sinal, B-1 1' 0' 1' 8' 3' 6' 1' ur + Vent connector only 'Accessibility clearance shall lake precedence where greater Specifications and Performance Data are Subject to Change Without Notice. .�...■■■.■■ ■�:����...■■ ■■ummm�■■■■ r■■.KU►UO■■■ ■■■■► EMOO■■ ■■■■E ■■m■ k■ M■■ ■■\\■., E� ■■■S I TEMPERATURE RISE (F) - NATURAL W 111 6] 76 66 61 56 51 46 .3 40 37 05 Ga 0.7 0.6 OA 0.{ 0.3 03 GMP075-S 0.1 1/3HP Yt11 10 . 6 BIWR. 0 500 600 700 600 600 1000 1100 1700 I� 1400 15M 1600 (FM - NO FITERS TEMPERATURE R6E (1) - RATURK GAS 173 106 03 a7 76 67 60 57 53 46 .8 66 o.a 0.7 0.6 0.5 0.6 0.5 0.2 GMPIOG-S --'._•_ 0.1 _ 1 /LIP MTR - - - - - 10 . a 6LWR. 0 SW 700 $00 600 1000 I100 1000 1500 14M 1500 I600 1700 CFM - NO FILTERS XWWIIE 65E I) . WMR. 0A 606 0 0 7/ 0 0 0 0 II ■ N 61 7 0 i 51 31 61 i k G 1 t I 7■ O 6r A01 Ib 1i0 0r I" 11m Ili IA wo 10 200 Ar 0® ]Ur 5101 Eli AW - 01667a OI.1WY[RII-W16.W.N 116 l0 A M A /1 Y i i i /1 Y Y M■■ i A i bl■■■■►■■.■NN■■■■■ ■■■o■■■■►■■■■■■■ \\■■■■►\.■■■.i\■ 3 TE1pEaA W IME p) - 1WN11E GAS M " 92 Y N aJ 01 41 N N u 41 /0 M A y CIA a7 0.5 1100 1700 1000 1100 0000 2100 22N 2700 2400 2500 2a10 2700 LN aN 3NO 7100 CM NO IFLUXI CASED (U) COIL APPLICATION OPTIONS FURNACE MODEL NO. GMP0503 GMP0753 GMPNO603 eGSU0603 GMP075-4 GMP1003 GMP100-4 GMPV075-1.513 GMPNO80-4 eGSU080-4 GMP100-5 GMP125-4 GMP125-5 GMPV1003/5 GMPV125,= GMPN100-4 eGSU100.4 GMP150-5 GMPN120-5 NOMINAL FURNACE WIDTH 14• 171i1• 21• 241/2• DFK MODEL NO. 3 DFK-14 DFK-17 DFK-21 DFK-24 COIL MODEL NO. NOMINALCOIL WIDTH U-18 14• X— U-29 14" X U30 17120 x 1 x 2 U31 14• x U32 17, • x, xz U35 14• x U36 17120 x 1 x z U-42 1712• x 1 x 2 U-47 17120 x U-49 21• X 1 X 2 U-59 21• X 1 X 2 U�0 241 • X 1 X 2 Ua, 24120 x, xz U-62 21 • 1 x 1 x 2 ............. —, . ... ..�...,1.. (2) . Dbcard bottom ceblat a1w pletes. (3) - Dw,Alow Col Ad.gr Kl alow, we of U coiM In dowNbw appl ad na •-Upilow AppYratlon" UC COIL INSTALLATION RECOMMENDATIONS: MINIMUM DISTANCE BETWEEN RMACE AND COIL PAN: 21 GAS FURNACE Note: DFK(3) H�l w nw.wc A. Do not we thle coil on of fnrcas or any applcattone whom the tanlpaabee a1 drain pan may exceed 300'F. Use to blwrq metal drain pen: 1523618 (ule OYU U-02).1 SMO-19 (tied Oyu W7).15238-20 (U&C aW aru L411 and 15236-12 (UA". U-N. and U44 for time appkation. B. Due to the m*V nt11 match of Varian colts with outd00f taJh it is IrWitart to match the Unsce air flow for We bfal syatsm capacity. QUIer to tumace "a shod l cadener/hed pLEW spea abet) ea Al I a KOVI-11=1S la► 4 niv I'l,.• ETA •l0I0l10to 10 SEER SPLIT SYSTEM HIGH EFFICIENCY AIR CONDITIONING 1 1/2 THRU 5 TON 16.28 to 17.56kv1/] Description / Application • Outdoor condensing units for ground level or rooftop application. • Designed for use with evaporator blowers and coils. Cabinet Construction • Powder paint finish with 500 hour salt spray approval. • Heavy gauge / zinc clad. SS-194D Standard Equipment • Copper tube, aluminum fin coil construction. • Brass suction and liquid shut off valves with sweat connections. • Fully charged for 15' [4.57m] tubing length. • Totally enclosed pemmanenty lubricated condenser motor. • Quiet operating top discharge. • High efficiency performance. • Designed for PSC operation. • Hermetically sealed compressor. • Liquid line filter drier, factory Installed. Made In the USA by: Goodman Manufacturing Company, LP. 1501 Seamist - Houston. Texas 77008 CK SERIES 11100 Phvsical Data Model Liquid Connection Suction Connection T Type Approx. Shipping Welclht CK18-1 3/8' 19.5mml 314' rl9mm Sweat 125lbs. 56.7k ql CK24-1D/1E 3/8" 9.5mm 3/4' 19mm Sweat 127lbs. 57.6k qI CK30-1D 3/8" 9.5mm 3/4' rlgmml Sweat 130lbs. 159.Okql CK36-1D/1EAW 3/8' 9.5mm 3/4' (19mml Sweat 142lbs. 64.4k ql CK42-1A 3/8' 9.5mm 7/8"[22.2mml Sweat 1 160lbs. 2.6k ql CK49.11-3 3/8' r9.5mml 7/8' [22.2mml Sweat 1 176lbs. 9.8k ql CK60-1/-1A/-3/-4 3/8' 9.5mm 7/8' 22.2mm Sweat 2081bs. 94.3k CK62-IA 3189.5mm 7/8' [22.2mml Sweat 1 258lbs. it17.0k qj DIMENSIONAL DATA CK1M2 MODELS SMALL CHASSIS-2T luml LARGE CHASSIS-29' "7 ' 0 SMALL CHASSIS-Zr 15kml LARGE CHASSIS-2r 173cm) CK18. 24. 30-22.5157cm] CK36.2S 163cm] small CK42.30'r76cml Chassis C il)-25'163cml CK60m=176cml 1 wge CK62-37.5' 195cm1 } dussis --1•vs•12e.smm]Dw.POWER � 7/r 122.2mm] DLACONTROL SUCTION CONN. LIQUID CONN. ADDITIONAL 1.12" 138.1mm] ELEVATED CHANNEL FORMED INTO BOTTOM PAN Elactrir_ai nnta Model CK18-1 Volts 20W30 PH 1 +Minimum Circuit Ampacity 12.5 *Maximum Overcurrent Protection 20 Maximum Volts 253 Minimum Volts 197 Com ressor Cond. Fan Rt11 9.0 I LRA FLA HP CK24-ID 208/230 1 16.4 20 253 197 12.1 45 57 1.3 1.3 1/6 1/6 CK24-tE 208/230 1 14.9 20 253 197 10.9 60.0 1.3 116 CK30-ID 208/230 1 18.9 30 253 1 197 14.1 73 1.3 1/6 CK36-ID 208/230 1 22.9 40 253 1 197 17.3 89 1.3 116 CK36-1E 208230 1 19.9 30 253 1 197 16.6 96.0 1.3 1/6 CK36-3D 208230 3 1 14.2 20 253 1 197 10.3 1 78 1.3 1/6 CK42-IA 208230 1 1 40 253 197 17.2 1 48.0 1.3 116 CK49-1 208230 1 1 26.8 40 253 197 20.0 110 1.8 114 CK49-3 208230 3 17.8 30 253 197 12.8 78 1.8 1/4 CK60-1 208/2 00 1 33.1 50 253 197 25.0 150 1.8 1/4 CK60-IA 208230 1 37.9 60 253 197 28.9 165 1.8 1/4 CK60-3 208230 3 21.1 30 253 197 15.4 124 1.8 1/4 CK60-4 460 3 11.1 15 506 414 7.4 59.6 1.8 1/4 CK62-IA 208230 1 36.1 60 253 197 27.1 175 2.3 1/3 'Mav use fuses or HACR tvnw Clrmit RrA.L-. - • •� e . -t-_ _. __._. +wire size should be determined in accordance with National Electrical Codes. Extensive wire runs will require larger wire sizes. [ ] Designates metric equivalents SS-194 Performance Ratlnna `J Condenser Model Evaporator Model Total BTUH rkWWl Sensible BTUHrkWI (1) SEER (2) EER SRN/BELS AW18-XX 16400 [4.81 12200 [3.6] 10.00 9.00 AC18-XX 17000 [5.01 12600 13.71 10.00 9.00 AWB18-MACH18 16800 14.91 12400 13.61 10.00 9.00 AW24-XX 17000 15.01 12700 [3.71 10.00 9.00 CK18-1 AR18.1 U18/UCIB+EEP 17000 17000 [5.01 [5.01 12700 12700 [3.7] 13.7] 10.00 10.00 9.00 9.00 AH18 17400 [5.11 12900 13.81 10.00 9.00 8.0(4) AR24-1 17400 15.11 13200 [3.9] 10.00 9.00 U29/UC29+EEP 17400 [5.1] 12700 (3.7) 10.00 9.00 HT1830/H24F+EEP 17400 15.11 13200 [3.91 10.00 9.00 U31+EEP 18000 15.31 13100 13.81 10.50 9.50 AR32-1 18000 15.31 13500 14.01 10.50 9.50 AER24-1 18000 15.3] 13500 14.01 11.00 10.00 HT3236lH36F/U32/UC32+EEP 18000 rs.3113500 4.0 10.50 9.50 AW24-XX 22600 16.61 16800 [4.91 10.00 9.00 AW30-XX/AR24-1 23000 16.71 17200 15.01 10.00 9.00 U29/UC29+EEP 23000 (8.71 17200 15.01 10.00 9.00 HT1830/H24F+EEP 23000 [6.71 17200 [5.0] 10.00 9.00 CK24-11)/1E AC24-XX AWB24-XX/ACH24/AH24 23200 23200 (6.81 16.81 17200 17200 15.0] (5.01 10.00 10.00 9.00 U31+EEP 24000 [7.01 18400 15.4] 10.50 9.00 9.50 6.0(4) U36/UC36/H36F+EEP 24000 [7.0) 18400 (5.4] 10.50 9.50 HT3236/U32/UC32+EEP 24000 [7.0] 18400 [5.4] 10.50 9.50 AR32-1 24000 [7.0J 18400 15.41 10.50 9.50 AER24-1 24000 r7.oi 18400 r5.41 11.00 10.00 AWB30-XX/AW30-XX 27000 p.91 20000 (5.9] 10.00 9.00 U29/UC29+EEP 27000 [7.9] 20000 15.91 10.00 9.00 AR3a-1 27200 18.01 20500 [6.0] 10.00 9.00 HT7830/U30+EEP 27200 18.01 20500 [6.01 10.00 9.00 ACH30/AH30 28000 18.21 20750 [6.1] 10.00 9.00 CK301D AWB36-XX/AR36-1 28000 18.21 21200 [6.2] 10.00 9.00 U31+EEP 28000 [8.21 21200 [6.21 10.00 9.00 8.0(4) AC30-XX 28400 (8.31 21050 16.2] 10.00 9.00 HT3236/U32/UC32/H36F+EEP 28600 18.41 21800 16.41 10.00 9.00 AC36-=AH36 29000 18.51 21500 [6.31 10.00_ 9.00 -29000- [8.51 -- 21800 - -16.41- _ -10.50 _ -9.50 AER30-1 28000 18.21 21000 16.2] 10.50 9.50 AER36-1 HT4248/U42/UC42M49F+EEP 29000 29000 18.51 8.5 22100 22100 16.5] 6.5 11.00 10.50 10.00 ACH36 32000 19.41 23000 [6.7] 10.00 9.50 9.00 U35/UC35+EEP 33000 19.71 24000 [7.01 10.00 , 9.00 AC36-XX 33200 110.01 24600 [7.2] 10.00 9.00 CK36- HT36N361UC36/H36F+EEP 34000 110.01 25200 [7.4] 10.00 9.00 1D/1E/31) HT3236+EEP AWB36-XX/AR36-1 34400 34000 110.31 110.11 25500 25200 [7.51 VA) 10.00 10.00 9.00 8.0(5) AH36 34400 110.31 25500 [7.51 10.00 9.00 9.00 AR42-1 HT4248/U42/UC42/H49F+EEP 35000 35000 110.31 110.31 26600 26000 [7.81 17.61 10.50 10.50 9.50 AER36.1 35000 r10.37 26000 r7.61 11.00 9.50 10.00 U42/UC42+EEP 39500 [11.61 27300 (8.0] 10.00 9.00 AR42-1 40000 111.71 28000 18.21 10.00 9.00 HT4248/H49F+EEP 40000 111.71 28000 18.21 10.00 9.00 CK42-1A U47/UC47+EEP AR48-1 40000 [11.71 28000 18.21 10.00 9.00 U49/UC49+EEP 40000 40500 111.71 111.91 29600 28200 [8.7] [6.31 10.00 10.00 9.00 AR49-1 41000 112.01 30400 [8.9] 10.50 9.00 9.50 8.2(5) HT4860/U60/UC60/H60F+EEP 41000 112.01 30400 [8.9] 10.50 9.50 AER48-1 41000 .112.01 1 30200 18.81 11.00 10.00 [ I Designates metric equivalents SS-194 3 Per armanra Ratinne Condenser Model Evaporator Model Total BTUH Sensible BTUH tkffl 1 (1) SEER (2) EER SRWBELS HT4248/H49F+EEP 44000 [12.9] 33000 [9.7] 10.00 9.00 U47/UC47+EEP 44000 (12.91 33000 (9.7] 10.00 9.00 HT4860/H60F+EEP 45000 113.21 34200 [10.0] 10.00 9.00 CK49-1/3 AR48.1 U49/UC49+EEP 45000 45000 [13.2] (13.2] 34200 34200 110.01 (10.01 10.00 10.00 9.00 U59/UC59/U60/UC60+EEP 46000 113.51 35000 [10.0] 10.00 9.00 9.00 8.2(5) AR49.1 46000 [13.51 35000 [10.3] 10.50 9.50 HT61/H61F+EEP 47000 (13.8] 36000 (10.31 10.50 9.50 AER48-1 45000 . [13.21 34200 [10.51, 11.00 10.00 U59/UC59+EEP 54000 [15.8J 39500 (11.6] 10.00 9.00 AR60-1 56000 [16.4] 40300 111.81 10.00 9.00 HT486(k/U60/UC60/H60F+EEP 55000 [16.11 39600 [11.6] 10.00 9.00 CK60- HT61/H61FA)61NC61+EEP 56000 (16.41 39500 [11.6] 10.50 9.50 8.2(5) 1/tAl3/4 U62/UC62+EEP 66000 (16.4] 39500 (11.61 10.50 9.50 AR61-1 57000 [16.7] 42000 (12.3] 10.50 9.50 AER60.1 57000 f 16.71 42000 12.3 10.50 1 9.50 AR60.1 58000 117.01 45000 [13.2] 10.00 9.00 U59/UC59+EEP 58000 [17.0] 42000 [12.3] 10.00 9.00 HT4860/U60/UC60+EEP 58000 [17.0] 42000 112.31 10.00 9.00 CK62-1A U61/UC61+EEP U62/UC62+EEP 60000 60000 (17.61 [17.6] • 43000 43000 [12.6] (12.6] 10.00 10.00 9.00 HT61/H61F+EEP 60000 [17.6] 43000 112.61 10.00 9.00 9.00 8.2(5) AR61-1 62000 [18.2] 45000 (13.2] 10.00 9.00 AER60.1 61000 17.9 45000 13.2 10.50 9.50 (1) Seasonal Enerav Erfiaianev Patin (2) Energy Efficiency Ratio 080'17/67-F (26.6'C/19.4'C] Inside - 95'F [350C] (3) When matching the outdoor unit to the Indoor unit, use the piston supplied with the outdoor unit or that specified on the piston kit chart supplied with the Indoor unit (4) SRN 7.6 with use of Sound Blanket accessory CSB-01. (5) SRN 7.8 with use of Sound Blanket accessory CSB-01. (6) Note: XX Of A Model Designate Electric Heat Quantity. (7) EEP - Order From Service Dept Part No. B13707-38. The Goodman Gas Furnace contains the EEP cooling time delay. [ ] Designates metric equivalents NOTE: SPECIFICATIONS AND PERFORMANCE DATA LISTED HEREIN ARE SUBJECT TO CHANGE WITHOUT NOTICE SS-194 4 LENNOX HEARTH PRODUCTS MPD-3530 MODEL SHOWN RETAIN THESE INSTRUCTIONS FOR FUTURE REFERENCE ----- -----__WamockHersey__----- `_• I WH Report No. J20006711." C .e M WARNING: IFTHE INFORMATION IN THIS MANUAL IS NOT FOLLOWED EXACTLY, A FIRE OR EXPLO- SION MAY RESULT CAUSING PROPERTY DAM- AGE, PERSONAL INJURY OR LOSS OF LIFE. FOR YOUR SAFETY: Do not store or use gasoline or other flammable vapors or liquids in the vicin- Ity of this or any other appliance. FOR YOUR SAFETY: What to do if you smell gas: • DO NOT light any appliance. • DO NOT touch any electrical switches. • DO NOT use any phone in your building. • Immediately call your gas supplier from a neighbor's phone. Follow your gas suppliers instructions. • If your gas supplier cannot be reached, call the fire department. Installation and service must be performed by a qualified installer, service agency or the gas supplier. HOMEOWNER'S CARE AND OPERATION INSTRUCTIONS DIRECT -VENT MPD-33/35/40/45 SERIES VENTED GAS FIREPLACE HEATERS - DIRECT VENT MODELS P/N 875,014M REV. C 05/2002 S' Millivolt Models Electronic Models MPDT-3328CNM MPD4035CNM MPDT-3320CNE MPD4035CNE MPDT-3328CPM MPD-4035CPM MPDT-3328CPE MPD-4035CPE MPDR-3328CNM MPD-4540CHM MPDR-3328CNE MPD-454OCNE MPDR-3328CPM MPD-4540CPM MPDR-3328CPE MPD-4540CPE MPD-353OCNM MPD-353OCNE MPD-3530CPM MPD-3530CPE AVERTISSEMENT: ASSUREZ-VOUS DE BIEN SUIVRE LES INSTRUCTIONS DONNE BANS CETTE NOTICE POUR REDUIRE AU MINIMUM LE RISQUE WINCENDIE OU POUR WTER TOUT DOMMAGE MATERIEL, TOUTE BLESSURE OU LA MORT. POUR VOTRESECURITE: Nepas entreposerniutiliser d'essence ni d'autre vapeurs ou liquides inflammables dans le voisinage de cot appareil ou de tout autre appareil. POUR VOTRE SECURITE: Que falre sl vous sentez une odeur de gaz: • Ne pas tenter d'allumer d'appareil. • Netouchezhaucuninterrupteur. Nepasvousservir des taldphones se trouvant dans le batiment oD vous vous trouvez. • Evacuez la pidce, le b9liment ou la zone. • Appelez immddiatement votre fournisseur de gaz depuis un Voisin. Suivez les instructions du fournisseur. • SI vous ne pouvez rejoindre le fournisseur de gaz, appelez le service dos incendles. L'installationetservicedoitEtreextscutdparun qualifid installeur, agence deservice ou lefournisseurde gaz. CONGRATULATIONS In selecting this LENNOX Direct -Vent Gas Appliance you have chosen the finest and most dependable fireplace to be found anywhere. A beautiful, prestigious, alternative to a wood burning fireplace. Welcome to a Family of tens of thousands of satisfied LENNOX Fireplace Owners. Please read and carefully follow all of the instructions found in this manual. Please pay special attention to the safety Instructions provided in this manual. The Homeowner's Care and Operation Instructions included here will assure that you have many years of dependable and enjoyable service from your LENNOX product. TABLE OF CONTENTS Introduction ................. _....... .......... page 2 General Information...._ ................... page 2 Operation/Care of Your Appliance.... page • • 3 Gas Controls/Compartment Access. papa 3 Variable Flame Adjustment ............. page 4 Glass Cleaning ................................. page 4 Maintenance .................................. page 4 Maintenance Schedule ......... ........... page 5 Front Glass Enclosure Panel, Removal and Installation .........._... page 6 Burner Adjustments_ ....................... page 6 Flame Appearance and Sooting ....... page 6 Adjustment ......................... _........... page 7 Log Placement ....... ........................ page 7 Rockwool Placement......_ ............... page 8 Vermiculite Placement ..................... page 8 Volcanic Stone Placement .............. page 8 Millivolt Appliance Checkout ......... page 8 Electronic Appliance Checkout ...... _. page 8 Wiring Diagrams ............... page 9 Warranty ..................................... _... page 9 Replacement Parts ....................... page 9 Product Reference Information ....... page 9 Accessory Components ............ ...... page 10 Lighting Instructions —Millivolt....... page 12 Lighting Instructions —Electronic.... page 14 Troubleshooting Guide— Millivolt._.. page 16 Troubleshooting Guide— Electronic.. page 17 Replacement Parts List _....... _.... _.. page 18 INTRODUCTION The Fireplace models covered in this manual are Direct -Vent sealed combustion vented gas fireplace heaters designed for residential ap- plication. Direct -Vent appliances operate with the combustion chamber completely isolated from the Inside atmosphere. All air for com- bustion is brought in from the outside and exhaust gases are vented through the same direct vent, vent system. The millivolt appliances are designed to oper- ate on either natural or propane gas. A millivolt gas control valve with piezo Ignition system provides safe, efficient operation. External electrical power is required to operate the optional electrically powered components if Installed. Electrical power must be wired during appliance Installation. The electronic appliances are designed to op- erate on either natural or propane gas. An electronic Intermittent pilot system provides safe, efficient operation. External electrical power is required to operate these units. These appliances comply with National Safety Standards and are tested and fisted by Warnock Hersey (Report No. J20006711) to ANSI Z21.88-2000 (in Canada, CSA-2.33-2000), and CAWCGA-2.17-M91 In both USA and Canada, as vented gas fireplace heaters. Installation must conform to local codes. In the absence of local codes, installation must comply with the current National Fuel Gas Code, ANSI 7223.1(NFPA54).(In Canada, the current CAN/CGA B1 49 installation code.) Elec- trical wiring must comply with local codes. In the absence of local codes, Installation must be in accordance with the National Electrical Code, NFPA 70 - (latest edition). (In Canada, the currentCSAC22.1 Canadian Electric Code.) DO NOT ATTEMPT TO ALTER OR MODIFY THE CONSTRUCTION OF THE APPLIANCE OR iTS COMPONENTS. ANY MODIFICATION OR ALTER- ATION MAY VOID THE WARRANTY, CERTIFICATION AND LISTINGS OF THIS UNIT. WARNING: IMPROPER INSTALLATION, ADJUSTMENT, ALTERATION, SERVICE OR MAINTENANCE CAN CAUSE INJURY OR PROPERTY DAMAGE. REFER TO THIS MANUAL. FOR ASSISTANCE OR ADDITIONAL INFORMATION CONSULT A QUALIFIED INSTALLER, SERVICE AGENCY OR THE GAS SUPPLIER. GENERAL INFORMATION Note. Installation and repair should be per- formedbya qualified service person. Theapp/f- ance should be inspected annually by a quali- fied professional service technician. More fre- quent inspections and cleanings may be re- quired due to excessive lint from carpeting, bedding material, etc. It Is imperative that the control compartment burners and circulating airpassage ways ofthe appliance be kept clean. S assurer quo le bruleur at le compartiment des commandes sont propres. Voir les in- structions d'installation at d'utilisalion qui accompagnent I'appareit Provide adequate clearances around air open- ings and adequate accessibility clearance for service and proper operation. Never obstruct the front openings of the appliance. D ue to high temperatures the appliance should be located out of traffic and away from furni- ture and draperies. Locate furniture and win- dow coverings accordingly. WARNING: THESE FIREPLACES ARE VENTED HEATERS. DO NOT BURN WOOD OR OTHER MATERIAL IN THESE APPLIANCES. These appliances are designed to operate on natural or propane gas only. Input of millivolt models Is variable. These rates are shown in the following tables: Millivolt Models with Manually -Modulated Gas Valve Natural Gas Model Series Input rate (STU/H) MPDT-3328 MPDR-3328 11,700 to 17,500 MPD-3530 12,800 to 20,000 MPD-4035 18,500 to 27,000 MPD-4540 20,5D0 to 29,DW Millivolt Models with Manually -Modulated Gas Valve PROPas Gas Model Series Input rate (11TUi11) MPD -3328 MPDR-3328 14,000 to 17.500 MPD-3530 15,200 to 20.000 MPD-4035 21=to27,000 MPD-4540 22,500 to 29,000 Electronic Models - Electronic models have a foxed rate gas valve. Input of electronic models is shown in the following table: Electronic Models with Flied -Rate Gas Valve Natural and Propans Gas Model Series Input rate 11T11IH MPDR-3328 17,500 MPo-3530 20,000 MPD-403s 7 MFU-4540 The following table shows the units' orifice size for the elevations Indicated. Model orifice size Elevation Series Feet (motors) Nal. Prop. MPDT-3328 145 0.048Inch MPDR-3328 G 4500 MPD-3530 144 155 (0-1370) MPD-4035 137 0.062 inch MPD-4540 136 052 Maximum manifold pressure is 3.5 in. w c. (0.87 kPa) for natural gas and 10 in. w.c. (2.49 kPa) for LP/Propane gas. Do not use these appliances if any part has been underwater. Immediately calla qualified, pro- fessional service technician to Inspect the ap- pliance and to replace any parts of the control system and arty gas control which have been under water. Ne pas se servir de cet apparel s'g a 08 plong8 dans 1'eau, compi6tement ou en parts. Appeler un technicien qualifi8 pour inspector I'appareil et remplacer touts parts du systbme de contr8le et touts commands qui ont6116 plonrgdsdans I'leau. Test gage connections are provided on the front of the millivolt gas control valve (identi- fied OUT for the manifold side and IN for inlet pressure. A L5' NPT test gage connection is provided on the electronic gas control valve adjacent to the outlet to the main burner. Minimum inlet gas pressure to these appliances is 5.0 inches water column (124 kPa) for natural gas and 11 Inches water column (2.74 kPa) for propane for the purpose of input adjustment Maximum inlet gas supply pressure to these appliances is 10.5 Inches water column (2.61 kPa) for natural gas and 13.0 inches water column (3.23 kPa) for propane. The appliance must be isolated from the gas supply piping system (try closing its individual manual shut-off valve) during any pressuretest- ing of the gas supply piping system at test pressures equal to or less than %psig (3.5 kPa). The appliance and its individual shut-off valve must be disconnected from the gas supply piping system during arty pressure testing of that system at pressures In excess of % psig (3.5 kPa). These appliances must not be connected to a chimney or flue serving a separate solid fuel burning appliance. Any safetyguard or screen removed for servic- ing the appliance must be replaced prior to operating the appliance. WARNING: FAILURE TO COMPLY WITH THE INSTALLATION AND OPERATING IN- STRUCTIONS PROVIDED INTHIS DOCU- MENT WILL RESULT IN AN IMPROP- ERLY INSTALLED AND OPERATING AP- PLIANCE,VOIDINGiTSWARRANTY. ANY CHANGE TO THIS APPLIANCE AND/OR ITS OPERATING CONTROLS IS DANGER- OUS. IMPROPER INSTALLATION OR USE OF THIS APPLIANCE CAN CAUSE SERIOUS INJURY OR DEATH FROM FIRE, BURNS, EXPLOSION OR CARBON MON- OXIDE POISONING. Carbon Monoxide Poisoning: Early signs of carbon monoxide poisoning are similar to the nu with headaches, dizziness and/or nausea. If you have these signs, obtain fresh air Immedi- ately. Turn off the gas supply to the appliance and have It serviced by a qualified profes- sional, as it may not be operating correctly. WARNING: CHILDREN AND ADULTS SHOULD BE ALERTED TO THE HAZARDS OFHIGH SURFACETEMPERATURES. USE CAUTION AROUND THE APPLIANCE TO AVOID BURNS OR CLOTHING IGNITION. YOUNG CHILDREN SHOULD BE CARE- FULLY SUPERVISED WHEN THEYARE IN THE SAME ROOM AS THE APPLIANCE. WARNING: DO NOT PLACE CLOTH- ING OR OTHER FLAMMABLE MATERI- ALS ON OR NEAR THIS APPLIANCE. AVERTISSEMENT: SURVEILLER LES ENFANTS. GARBER LES VETEMENTS, LES MEUBLES, L'ESSENCE OU AUTRES LIOUIDES A VAPEUR INFLAMMABLES LOIN DE L'APPAREIL. OPERATION AND CARE OF YOUR APPLIANCE Appliance operation may be controlled through a remotely located optional wall switch. Sepa- rate switches may provide Independent control for the remote controlled fireplace operation (optional equipment), s In lieu of remote or remote wall switch opera- tion, the appliance must be operated directly through the controls located on the front of the valve located within the control compartment which is located behind the control compart- ment access panel below the appliance front glass enclosure panel. See Figure 1. Gas Controls/Control Compartment Access The gas controls can be found behind the control compartment access panel. _To open the control compartment access panel, actuate the spring -loaded magnetic catches securing the panel, by gentry depressing the outer top corners of the panel until the catches 'pop'the door free, allowing it to swing out and down to open. Operation of millivolt and electronic gas con- trol systems are different. Before lighting and operating your appliance determine if you have a millivolt or electronic appliance. See Figure 1 on page 4 for access to the control compartment. Millivolt appliances will be fitted with the gas control valve shown in Figure 2 on page 4. Appliances with electronic systems will be fitted with the electronic valve shown in Figure 3 on page 4. Familiarize yourself with the gas control valve that your appliance uses. Millivolt Appliaaces - To light millivolt appliances refer to the de- tailed lighting Instructions Iound on page 12 (English) and page 13 (French). Millivolt appliance lighting instructions may also be found on the pull-out lighting instruction labels attached to The gas control valve. Refer to Figure 2 for the location of the piezo ignitor. Control Compartment Access k< Control Compartment lit din Acton Panel Plano Ignitor Honeywell Millivolt Gas Valve Shown Millivolt Control Valve Shown Figure 1 Millivolt appliances may be fitted with an op- tional burner OWOFF Rocker Switch. The op- tional OWOFF Rocker switch will be Installed In the bracket just beneath the gas control valve. Once the pilot is lit, the OWOFF rocker switch will control the appliance OWOFF op- eration. To operate: Toggle the switch be- tween its ON and OFF positions. If your millivolt appliance is equipped with an _ optional remote wall switch or remote control kitandthe pilotis litthe appliance main burner may be turned on and off with the wall switch or remote control. Electronic Appliances - To light electronic appliances refer to the de- tailed lighting Instructions found in both En- glish and french on pages 14and 15of these instructions respectively. Electronic appliance lighting Instructions mayalso be found on the pull out lighting Instruction labels attached to the gas control valve. If your electronic appli- ance is equipped with an optional remote wall switch or remote control kit the appliance main burner may be turned on and off with the wall switch or remote control. If your electronic appliance Is not equipped with a wall switch or remote control, the main burner must be turned off and on with the gas control switch. Toggle the switch from ON to OFF to operate the main burner. Wellold Pressure Pod OKWF Swilce Inlet O •O Patsure of o Electronic Gas Control valve Figure 3 Honeywell Electronic Gas Valve Variable Flame Height Adjustment ( Millivolt Appliances only) 1. All Millivolt appliances are equipped with a variable gas control valve. Flame height for these models may be adjusted through a range between fixed low and high settings, alternately, while the appliance is in opera- tion. Adjust the flame height as desired after lighting the appliance by rotating the vari- able adjustment control knob located on the front of the valve (refer to Figure 2). 2. When litfor the first time, this appliance will emit a slight odor for an hour or two. This is due to the `burn -in" of internal paints and lubricants used In the manufacturing process. 3. Keep lower control compartment clean by vacuuming or brushing at least twice a year. More frequentcleaning may be required due to excessive lintfrom carpeting, bedding materi- als, etc. It is Important that control compart- ments, burners and circulating air passage- ways of the appliance be kept clean. O 67- r��•) NOTE DNGR" a ILLUSTMTIONS NOT 10 SCALE 4. Always turn off gas to the pilot (millivolt appliances) before cleaning. Before relight- ing, refer to the lighting instructions in this manual. Instructions are also found on a pull- out panel located on the floor of the appliance. 5. Always keep the appliance area clear and free from combustible materials, gasoline and other flammable liquids. 6. Remember, Millivolt appliances have a con- tinuous burning pilot flame. Exercise caution when using products with combustible vapors. Glass Cleaning It will be necessary to clean the glass periodi- cally. During start-up it is normal for conden- sation to form on the Inside of the glass. This can cause lint, dust and other airborne par- ticles to cling to the glass surface. Also initial paint curing may deposit a slight film on the glass. It is therefore recommended that the glass be cleaned two or three times with a non - ammonia household cleaner and warm water (a gas fireplace g lass cleaner is recommended). After that the glass should be cleaned two or three times during each heating season, de- pending on the circumstances present Note: clean glass after first two weeks of operation. WARNING: 00 NOT USE ABRASIVE CLEANERS. NEVER CLEAN THE GLASS WHEN IT IS HOT. CAUTION: DO NOT ATTEMPT TO TOUCH THE FRONT ENCLOSURE GLASS WITH YOUR HANDS WHILE THE FIREPLACE IS IN USE. Maintenance The appliance and venting system should be thoroughly Inspected before initial use and at least annually by a qualified service techni- cian. However, more frequent periodic inspec- tions and cleanings should be performed by the homeowner. Homeowner must contact a qualified service technician at once if any abnormal condition is observed. Refer to the maintenance schedule for main- tenance tasks, procedures, periodicity and by whom they should be performed. Always verify proper operation of the appliance af- ter servicing. IMPORTANT: TURN OFF GAS AND ANY ELEC- TRICAL POWER BEFORE SERVICING THE APPLIANCE. Maintenance Schedule Annually (Before the onset of the Burning Season) Maintenance Task Accomplishing Person Procedure Inspecting/Cleaning Burner, Logs Qualified Service Technician Inspectvalveand ensure his properlyoperating. and Controls Check piping for teaks. Vacuum the control compartment, fireplace logs and burner area. Check Flame Patterns and Flame Height Qualified Service Technician Refer to Figure 6 (MPD-3328), 7(MPD-3530) or 8 (MPD-4035, MPD-4540) on page 7 and verity the flame pattern and height displayed by the appliance conforms to the picture. Flames must not Impinge on the logs. Inspecting/Cleaning Pilot and Burner Qualified Service Technician Refer to Figure 9 (Millivolt) or Figure 10 (Electronic) on page 8. Remove any sur- face build-up on pilot and burner assembly. Wipe the pilot nozzles. Ignitor/flame rod and hood. Ensure the pilot flame engulfs the flame sensor as shown. Checking Vent System Qualified Service Technician Inspect the vent system at the top and at the base (within the firebox) for signs of blockage or obstruction. Look for any signs of disloca- tion of the vent components. Appliance Checkout Qualified Service Technician Perform the appropriate appliance checkout procedure detailed in this manual. Replacing Rockwool Ember Materials Homeowner/Qualified Services Technician Remove old ember materials and vacuum the screened rockwool placement area. Place new rockwool as described in this document Periodically (After the Burning Season) Maintenance Task Accomplishing Person Procedure Cleaning Firebox Interior Homeowner Carefully remove logs, Rockwool and volca- nic stone H used. Vacuum out interior of the firebox Clean firebox walls and log grate. Replace logs, Rockwool and volcanic stone as detailed in this manual. Check Flame Patterns and Flame Height Homeowner Refer to figure 6(MPD%3?8), 7(MPD-3530) or 8 (MPD-4035, MPD-4540) on page 7 and verify the flame pattern and height displayed by the appliance conforms to the picture. Flames must not Impinge on the logs. Checking Vent System Homeowner Inspect the vent system at the top and at the base (within the firebox) for signs of block- age or obstruction. Look for any signs of dislocation of the vent components. Cleaning Front Glass Enclosure Panel Homeowner Clean as necessary following the directions provided in this manual. 00 NOT TOUCH OR ATTEMPT TO CLEAN GLASS WHILE HOT. -ont Glass Enclosure Panel, Removal id Installation. YARNING: NEVER OPERATE THE AP- 'LIANCEWITHOUTTHE GLASS ENCLO- WRE PANEL IN PLACE AND SECURE. 10 NOT OPERATE APPLIANCE WITH THE FRONT GLASS PANEL CRACKED, BRO- KEN OR MISSING. REPLACEMENT PAN- ELS ARE AVAILABLE THROUGH YOUR LOCAL LENNOX DEALER AND MUST BE INSTALLED BY A LICENSED OR QUALI- FIED SERVICE TECHNICIAN. rhese are direct -vent appliances. They are Designed to operate only with the front glass enclosure panel properly installed. Generally, the glass enclosure panel should not be re- moved except to gain access to the compo- nents within the firebox, and the appliance may only be operated without the front glass enclosure panel in place for very brief periods of time during Initial appliance checkout and adjustment During this appliance checkout and adjust- ment period, a potential safety hazard exists - EXERCISE EXTREME CAUTION to prevent the occurrence of any burn injuries from the exposed flames or hot surfaces. Also note, that while the front glass enclosure panel is removed, the flame appearance will appear to be smaller than normal. WARNING: HANDLE THE GLASS WITH EXTREME CAREI TEMPERED GLASS IS SUSCEPTIBLE TO DAM- AGE (SCRATCHES, FOR EXAMPLE) — HANDLE GLASS DOOR (GLASS EN- CLOSURE PANEL) GENTLY WHILE (REINSTALLING IT. WARNING: NO NOTATTEMPTTO SUB- STITUTE THE MATERIALS USED ON THIS DOOR, -OR REPLACECRACKED OR BROKEN GLASS WITH ANY MATE- RIALS OTHERTHANTHOSE PROVIDED BYTHEAPPLIANCE MANUFACTURER. THE GLASS DOOR OF THIS APPLIANCE MUST ONLY BE REPLACED AS A COM- PLETE UNIT AS PROVIDED BY THE MANUFACTURER. DO NOT ATTEMPT TO REPLACE BROKEN, CRACKED OR CHIPPED GLASS SEPARATELY. See Figure 4 and remove the front glass enclosure panel as follows: 1. Remove the top louver assembly or radiant panel. 2. Open the hinged drop -down control com- partment access panel. 3. Locate the two (2) latches at the top of the control compartment and disengage them f rom the floor frame bottom Vee-flange, pulling down on their handles to open them. 4. Swing the bottom of the door out and raise itslighty to lift the top flange of the doorframe away from the appliance. Top Flange Door Frame Glass Door , Latch 7 � Bottom Vee-tlange Late Door Frame Firebox Floor Figure 4 o Install the front glass enclosure panel, roceed as follows: . Retrieve the glass door frame. Visually nspect the gasket on the backside of the mnel. The gasket surface must be clean, free >f Irregularities and seated firmly. t. Position the door frame In front of the 'firebox opening and engage the top flange over the lip at the top of the firebox opening. 3. Swing the door down and back. Ensure the gasket seats evenly as the door draws shut. Engage the Vee-flange at the bottom of the door with the latches and close the latches to secure the door. 4. Reinstall the top louver assembly or radiant panel. Burner Adjustments The following paragraphs address burner ad- justment concerns and procedures. Flame Appearance and Sooting Proper flame appearance is a matter of taste. Generally most people prefer the warm glow of a yellow to orange flame. Appliances operated with air shutter openings that are too large will exhibit flames that are blue and transparent These weak blue and transparent flames are termed anemic. If the air shutter opening is too small sooting may develop. Sooting is indicated by black puffs developing at the tips of very long orange flames. Sooting results in black deposits forming on the logs, appliance inside surfaces and on exterior sur- faces adjacent to the vent termination. Sooting is caused by incomplete combustion in the flames and a lack of combustion air entering the air shutter opening. To achieve a wane yellow to orange flame with an orange body that does not soot, the shutter opening must be adjusted between these two extremes. No smoke or soot should be present Reposition the logs if - the flames Impinge on any of them, roTe ouAcnuu s uMTRATwes NOT To sour. If the logs are properly positioned and sooting conditions exist, the air shutter opening on the main burner tube should be adjusted Normally, the more offsets in the vent system, the greater the need for the air shutter to be opened further. WARNING: AIR SHUTTER ADJUST- MENT SHOULD ONLY BE PERFORMED BYAQUALIFIED PROFESSIONAL SER- VICE TECHNICIAN. ENSURETHAT THE FRONT GLASS PANEL IS IN PLACE AND SEALED DURING ADJUSTMENT. Adjustment CAUTION: THE ADJUSTMENT BOB AND NEARBY APPLIANCE SURFACES ARE HOT. EXERCISE CAUTION TO AVOID INJURY WHILE ADJUSTING FLAME APPEARANCE. To adjust the flame, move the adjustment rod (located In the lower control area) up or down to increase or reduce the air shutter opening, respectively. Initially, always position the air shutter to the factory setting (the minimum air opening position) as shown in Figure 5 on page 7. This can be done by pulling the adjustment rod all the way down. Allow the burner to operate for at least 15 minutes. Observe the flame continuously. If it appears weak or sooty as previously described, adjust the air shutter by pushing or pulling on the adjustment rod until the flame appearance is as desired. The adjustment rod and associated adjustable air shutter Is patented technology. Flame ad- justments can be made quickly and accurately to taste without the need of disassembling the appliance and wailing for 30 minutes after each adjustment. Propane models may exhibit a flame pattern that may candle or appear stringy. If this is problematic or persists as the appliance Is continually operated, adjust the air shutter closed as described in the previous para- graphs. Operate the appliance for a period of time as the effect diminishes, ensuring that the appliance does not develop sooty flames. When satisfied that the appliance operates properly, proceed to finish the installation. Leave the control knob in "ON" position and turn the remote switch "OFF." Close the lower control compartment door. Ad ueUng Se screw Adjustment Rod Up (Fully Dpeo oelUon veaturl \ Ali Shutter AdjustmDown ent (minimumimam air opening position) FACTORY AIR Models Gas SHUTTER Type SETTING - Inches mm MPDT-3328 Nat 1/32 0.8 Prop. 3/16 4.76 MPDR-3328 Nat. 1132(0.8) Prop. 3/16 4.76 MPD-3530 I Nat 1132(0.8) Prop. 3/16 (4.76) MPD-4035 Nat. 1/8 (32) Prop. 1/2 13 MPD-4540 NaL 1/8 3.2 Prop. 1 1/213 Figure 5 Log Placement WARNING: LOGS GET VERY HOT AND WILL REMAIN HOT UP TO ONE HOUR AFTER GAS SUPPLY IS TURNED OFF. HANDLE ONLY WHEN LOGS ARE COOL. TURN OFF ALL ELECTRICITY TO THE APPLIANCE BEFORE YOU INSTALL GRATE AND LOGS. WARNING: THIS APPLIANCE IS NOT MEANT TO BURN WOOD. ANY AT- TEMPT TO DO SO COULD CAUSE IR- REPARABLE DAMAGE TO YOUR AP- PLIANCE AND PROVE HAZARDOUS TO YOUR SAFETY. WARNING: THE SIZEAND POSITION ON THE LOG SET WAS ENGINEERED TO GIVE YOUR APPLIANCE A SAFE, RELI- ABLE AND ATTRACTIVE FLAME PAT- TERN. ANY ATTEMPT TO USE A DIF- FERENT LOG SET IN THE FIREPLACE WILL VOID THE WARRANTY AND WILL RESULT IN INCOMPLETE COMBUSTION, SOOTING, AND POOR FLAME QUALITY. NOTE DIAGRAMS a ILLUSTRATIONS NOT TO STALL Sk 17147 P931S 673630 06-2S-2003 S 11=41n 1, LOLA ABT, TRUSTEE OF YONKERS REALTY TRUST under written declaration of trust dated March 10, 1995 recorded with Barnstable County Registry of Deeds in Book 9595 Page 158, as amended by instruments rccordcd in Book 11244 Page 312 and Book 12466 Page 347 of 5049 Kensington High Street, Naples Florida 34105. in consideration, of One Hundred Seventy Thousand and 00/100 Dollars ($170,000.00) paid, grant to. WALDEN CORPORATION, a Massachusetts Corporation having its principal office at 218 Blue Rock Road. South Yarmouth, MA 02664 K/th QL'ITCL4IM COMANTS the land in Yarmouth, Barnstable County Massachusetts bounded and described as follows: NORTHWESTERLY by the Southeasterly sideline of Merchant Avenue, as shown on plan hereinafter mentioned, one hundred forty and 00/100 (140.00) feet; NORTHEASTERLY by Lot 29, as shown on said plan, one hundred thirty-three and 12/100 (133.12) feet; SOUTHEASTERLY by portions of Lots 43 and 42, as shown on said plan, one hundred thirty-seven and 98/100 (137.98) feet: and SOUTHWESTERLY by Lot 25, as shown on said plan, one hundred forty-eight and 761100 (148.76) feet. Being shown as LQj 27 on Plan of land entitled, "Subdivision Plan of Land in Yarmouth, Mass. for Merchant and Cassidy of Yarmouth, Inc. October 16, 1968 Scale 1" a 60' S.R. Sweetser Engineer Dennisport, Mass." duly filed in Barnstable County Registry of Dccds in Plan Book 225, Page 103, For title, reference is made to deed recorded in Book 9595, Page 165. Property address: 158 Merchant Avenue, Yarmouth, MA 02675. The undersigned hereby certifies that she is the sole trustee of Yonkers Realty Trust; that such Trust has not been altered, amended, revoked or terminated except as shown of record; and that she has authority of all of the beneficiaries to convey the property herein described, and to execute, acknowledge and deliver this instrument. A I � U40 V D .,1 `• Bk 171AP7 P0316 673630 Executed as a sealed instrument this 12 Y/4ay of 14Jooj eGY , 2003. STATE OF FLORIDA Colt.(,- C4 . , ss. Lola Abt, Trustee 3--J-f-/ 92003 Then personally appeared the above named LOLA ABT, TRUSTEE as aforesaid and acknowledged the foregoing instrument to be her free act and deed, before me. Notary Public My Commission Expires: Yrf UM ooi` 'ror M �nes:ru»s.mm �•.unw wrr ner�.e.rw M/Mm 11157ki ttt noQ000 aKrro FEE 1R1,ia cam •sei. o BARNSTABLE CDlNTY REGISTRY OF DEEDS COUNTY EXCISE TAX IRiTE 06.25.'03 NED Tax $387.60 TOTAL $387.60 CHEL'K $387.60 CLERK 1 NO.040650 TIME 11:27 1111 msTABLE REGISTRY OF DEEDS Mid• ' e CENTERS 1 1HE amCRER�5G.SPMYAMES 7 LEVEL COMMENTS PLANS DATED 08-07-03 16, A complete TJ—Xpert 2/' ACCESSORIES LIST Plot ID Length Product Plies Oty Rml 16, 1 1//• a 11' 1.3E TimberStrand LSL 1 5 Shl /' = 8' 23/320, 3//• Panels (2/' Span Rating) 1 19 Rm, Rim Board 38' 4• ;he Trus Joist Framer's Pocket Guide*1.6� ��/ JOIST AND BEAN LIST Plot ID Length ProductPlies Cry Al 24' 110 TJI/Pro-350 ioist 1 18 M1 10, 1 3/4' s 140 1.9E Microllam LVL 1 2 A`T nTJXp&t. `,X~ W- CREATED BY Mid -Cape Home Centers PO BOX 111E 465 ROUTE 134 SOUTH DENNIS, MA 02660 5083986071 FAX: 5097604499 JOB COMMENTS DUBLIN CONSTRUCTION 158 MERCHANT AVE YARMOUTHPORT MA SYMBOL LEGEND 1' Point Load _ Line Load T- ' Area Load ODetail Callout Label (See Framer's Pocket Guide) We aPx- W-z� or r TOWN OF YARMOUTH Building Department BUILDINCCS). (508) 398 2231 ext.261 PERMIT NO B-08-557 . PERMIT w ISSUE DATE : _ 10/24/2007- ; PROPOSED USE - - _ _ _ _ _ . ' APPLICANT ."-""'-----"."•'•---' JOB WEATHER CARD Robert .. . PERMIT TO ; MiscJretaining wall; AT (LOCATION) 10158MERCHANTAVE ZONING DISTRIC R-40 Bldg. Type: Residential SUBDIVISION MAP LOT BLOCK 1127.24 —� BUILDING IS TO BE: CONST P USE GROUP= LOT SIZE construct retaining wall as per plans dated 10/24/07. REMARKS AREA (SO FT) EST COST ($ OWNER JOBERG, ROBERT W ADDRESS 157 Venus Drive Worcester MA 01605 PERMIT FEE ($) $75.00 BUILDING DEPT BY CONTRACTOR LICENSE 080456 Holle, Robert P.O. Box 1101 Sagamore Beac MA 02562 5084934163 PHONE 15087769489 INSPECTION RECORD FIELD COPY Date �( Q' NoteProgrgDate Note - Corrections and Remark lnspectorCorrections and Remark Inspector 3'-�/r V O �/Jl�)/Y7//i C/J!O/wwileJl/J /7/trf) . pF YqR ONE & TWO FAMILY ONLY - BUILDING PERMIT O APPLICATION TO CONSTRUCT, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING kj y Town of Yarmouth Building Department H MAT?^"El1 � 1146 Route 28 ! Yarmouth, :NIA 02664-4492 Tel: (508) 398-2231 x261 • Fax: (508) 398-0836 ns- Office Use Only Planning Board Information Assessors Department Information: Type Map Lot Permit Nl�p' Date %n T e 41 Endorsement Date Permit Fee $ r Recording Date New Deposit Rec'd. $ Date I n No. 1.4 Propertyf 4;(,Dimensions: HOr Qa 3� 5f Net Due $��/ et iLo�tArea(sf) —Frontage (it) Lot Coverage This Section for Office Use Only Building Permit Umbpre Date Issued:' Id- Z, O% • Signature: Certificate of Occupancy is Is not required Building Official to Section 1 - Site Information I Use Group: R-4 Type: 5-B 1.1 Property Address: �� M A��. Yfa�1�-1ti►� 12 Zoning Information: � Zoning District Proposed Use 1.3 Building Setbacks (ft) nf0 1 -io CQO& e(AG�, ' G�•S�i^ re.K4;,n wKt. b Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided r - 1 A Water Supply (id.O.L. c. 40. S 541 Public — Private --- 1.5 Flood Zone drmallon: C I Zone: �� BFE: Annnf I I -�- _-•A I "JI 2.1 Owner of Record: UY N me (pri t) �c 5 Mailing Address VCnuSpnvfW0M1CS+[ 0160� o Sigma Telephone Fax E-mail 2.1 Authorized Agent: Name (print) Mailing Address Signature Telephone Fax E-mail 3.1 Licensed Construction Supervisor: Ro ber+ Ko Ie, ber Sege "9456 Addre S f1w,• Ex Ir ion to /2 Zvu Sign Telephone Fax E-mail 08- 3' Ib3 609 -7qS-0-% CompAny Name Flagistuitlon Number ` I D $ox 1(0) ct Mole c &o c,A -N: V1 Expiration Date Address - scc wiv+c — Signa Tel hone -0 455- "g- 3- 5,6 7- au ;n*d rfe 1 of 2 cwrl+ w6r% `w0"bVER ,� ► TOWN OF YARMOUTH F Building Department Town Hall Yarmouth, MA 02664 (508) 398.2231 ext.261 BUILDING PERMIT TRANSMITTAL Temp Permit No.: T-08-179 Applicant Name: Robert Holle Applicant Phone: 5084934163 Building Location: 0158 MERCHANT AVE Owner's Name: OBERG, ROBERT W Owner's Addres 57 Venus Drive Worcester MA 01605 Owner's Telephone: (508) 776-9489 REVIEWED BY: 1. WATER DEPARTMENT: 2. ENGINEERING DEPARTMENT: 3. CONSERVATION: 4. HEALTH DEPARTMENT: 5. BUILDING DEPARTMENT: 6. FIRE DEPARTMENT: COMMENTS: RECEIPT OF COPY: (OFFICE USE ONLY Recorded By. Ic Permit Fee: $0.00 Deposit Rec: $25.00 Payment Type: Check ChkNo.: 12961 Net Owed: ($25.00) Application Date: 10/23/2007 Issue Date: Expiration Date Comments: Mao/Lot: 127.24 construct retaining wall DATE: N/A: DATE: N/A: DATE: N/A: DATE: WA: DATE: N/A: DATE: WA: PLEASE NOTE SIGNATURE OF APPLICANT: DATE: Date Printed: 10/23/2007 TOWN OF YARMOUTH r�� sus BUILDING DEPART`IENT CONSTRUCTION SUPERVISOR FORM PLEASE PRINT: Job Location: 15b M&Zk',-V-AV- . Number p Street Village Owner of Property: W6fi O btro Construction Supervisor: ROb<e± 11 e CS W456 lb 8—liW VIO Name License No. Phone No. Address: �33 �o%�Ifcf f]vG , 131T'40 W Licensed Designee: — SEE Aeove- V — (If other than Supervisor) Name cpi rc At Swgawryo¢ ) License No. 2.15 Responsibility of each license holder: 2.15.1 The license holder shall be fully and completely responsible for all work for which he is supervising. He shall be responsible for seeing that all work is done pursuant to the state building code and the drawings as approved by the building official. 2.15.2 The license holder shall be responsible to supervise the construction, reconstruction, alteration, repair, removal or demolition involving the structural elements of building and structures only pursuant to the state building code and all other applicable laws of the commonwealth, even though he, the license holder, is not the permit holder but only a subcontractor or contractor to the permit holder. 2.15.3 The license holder shall immediately notify the building official in writing of the discovery of any violations which are covered by the building permit. 2.15.4 Anylicenseewho shall willfully violate subsections 2.15.1,2.15.2 or 2.15.3 or any other section of these .._. rules and regulations and any procedures, as amended, shall be subject to revocation or suspension of license by the board. 2.16 All building permit applications shall contain the name, signature and license number of the construction supervisor who is to supervise those persons engaged in construction, reconstruction, alteration, repair, removal of demolition as regulated by section 109.1.1 of the code and these rules and regulations. In the event that such licensee is no longer supervising said persons, the work shall immediately cease until a successor license holder is substituted on the records of the building department. 2.17 The license holder shall be responsible for requesting all required inspections. Failure to do so may be deemed a violation of the permit conditions. I have read and understand my responsibilities under the rules and regulations for licensing construction supervisors in accordance with section 109.1.1 of the state building code. I understand the construction inspection procedures and the specific inspection as called for by the building official. INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.152 Yes A No ❑ If you have checked yu, please indicate the type coverage by checking the appropriate box. A liability insurance policy J4 Other type of indemnity ❑ _ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Cha a eneral Laws, and that my signature on this permit application waives this requirement. Check one: SigKature of Owner or Owner's Agent Owner ❑ Agent Signature: Building Official Approval: For Office Use Only Permit No. Date TOWN OF YARMOUTH AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application MGL c. 142A requires that the 'reconstruction, alteration, 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 structures which are adjacent to such residence or building' be done by registered contractors, with certain exceptions, along with other requirements. Type of Work: W al, ConCfV Est. Cost 1'')000 Address of Work 166 047,lg Lk A AVC Yogny-dk PoeCt' Owner Name: R012e 1 D Date of Permit Application: to i6k1r I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under $1,000 Building not owner occupied Owner pulling own permit Other (specify) 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 pc nst qs, tV agepf to owner: Ddte If Contrac'tor Name Registration OR: Notwithstanding the above notice, I hereby apply for a permit as the owner of the above property: Date Owner Name TOWN OF YARMOUTH 1146ROUTE28 SOUTHYARMOUTH NL SSACHUSETTS02664-1451 Telephone (508) 398-2231, Ext. 261 — Fax (508) 398-2365 BUILDING DEPARTMENT DEMOLITION DEBRIS DISPOSAL AFFIDAVIT BUILDING ELEcnuCAL GAS PLUMBING SIGNS Pursuant to M.G.L. Chapter 40, Section 54 and 780 Cb1R, Chapter 1, Section 111.5, I hereby certify that the debris resulting from the proposed work/demolition to be conducted at 156 1 ea,144' 4wC j YgrAwAart Work Address is to be disposed of at the following location: A# mAfew 1�l &JI�/ LtY W -le' Said disposal site shall bea licensed solid waste facility as defined by M.G.L. Chapter 111, Section 150A. 1 Signature of Applicant Permit No. /4 / /g A ate : The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 iVashington Street Boston, MA 02111 www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Name • .:. �a/TAL>1�11i"lit����t�ttlwtrti�a.�•l 1101 Phone #: ' )lam Are you an employer? Check the appropriate box: 1.911 am a employer with Ig 4. ❑ I am a general contractor and I employees (full and/or part-time).' have hired the sub -contractors 2. ❑ 1 am a sole proprietor or partner- ship and have no employees working for me in any capacity. [No workers' comp. insurance required.] 3. ❑ I am a homeowner doing all work myself. [No workers' comp. insurance required.] t listed on the attached sheet. These sub -contractors have employees and have workers' cornp.insurance.t 5. ❑ 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' comm. insurance reouired.l Type of project (required): 6. ❑ New construction 7. ❑ Remodeling S. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions I I.❑ Plumbing repairs or additions 12.0 Roof repairs ) 13.1�jOther 011 UIlSj'lUfl •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 subcontractors and state whether or not those entities have employees. If the subcontractors 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 Policy # or Self -ins. Lic. #:1AA� —f5q — a,,� Expiration Date:: 1611N I UT Job Site Address: 158 Mff6 nt Ave �'� City/State/Zip: 0Zi1l-5- Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of NIGL 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 Invcstieations of the DIA for insurance coverage verification I do hereby certify un dStbf P ains �MXrSs rjury that the information provided above is true and correct Phone #: use City or Town: not write in this area, to be completed by city or town ofJiciaL Permit/License Issuing Authority (circle one): I. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone #• c ' `. �'i Qaaswmo+wnaalG4 o`.ii�aaaaaL.�aella • " Board of Building Regulations and Standards Corutruction Supervisor License Ucense: CS go456 Blrthdate: 2/12/1928 _ ! iExpin4qu ' 2/122009 _ US 119M r - Restriction 00 ROBERT C HOLiE 41•YMTCHER RW: S YARMOUTH, MA 02664 Commis}looer I ; I PINNACLE SITE CONTRACTORS, LLC • P. O. Box 1101 .Sagaafereikmeh, MA 02562 Name / Address Doreen & Robert Oberg 57 Venus Drive Worcester, MA 01605 "ACLE srM COMRACTORs, to Project 158 Merchant Avenue Yar nouthPort QUOTATION Date Quotation # 7/302007 I 2o06-212 DESCRIPTION I Total I DESCRIPTION of SERVICE: 1. Remove wood chips and excavate for construction of precast concrete segmental retaining wall. 2 " Construct retaining wall as shown on the attached plans using geosynthofic material (geogrid) and compacted gravel borrow as specified by the structural engineer. 3. Relocate and reuse existing guardrail as required. 4. The surface at the top of the filled area will be gravel matching the edge of the existing bituminous concrete and sloping gently toward the top of the wall. The existing pavement will not be disturbed. 5. Disturbed areas will be treated with wood chips or loamed and seeded as required. NOTES: Does not include building permit Pinnacle cannot guarantee against damage to existing drive. NOTE These services will be supervised by Pinnacle Site Contractors and the site plan(s) will be stamped (certified) by the Surveyor and Professional Engineer. TOTAL PROJECT AMOUNT: 1 29,870.00 TERMS: 113 Scheduling posit,1/3 at s of work.1/3 balance upon completion. Signed: Date -1 / -Q Z Signed: Date o_+ Total $29,870.00 Telephone: FAX eMa -- 508-743434W 508-743-NW annaclesiteoontraclors.com , BankofAmerica.�• 12961 _ � INNACLE SITE CONTRACTORS, LLC 5.13/110 10/17/2007 P.O. Box 1101 Sagamore Beach, MA 02562 PAY TO THE Town of Yarmouth "25.00 ORDER OF Twenty -Five and 001100 DOLLARS Town of Yarmouth 1146 Route 28 South Yarmouth, MA 02664-4492 - MEMO Merchant Ave. / Oberg BOO 1 296 LB' 1:01 L0001381: 94 L96 2059 26' BankofAmerica .�. 12956 1 INNACLE SITE CONTRACTORS, LLC 5-13/110 10/11/2007 P. O. Box i101 Sagamom Beach, MA 02562 PAY TO THE ORDER of Commonwealth of MA $ "100.00 One Hundred and 00/100"*m"-- _ """'••"'•""•""""""'« DOwws Commonwealth of MA P. O. Box 7070 Boston, MA 02204 MEMO 158 Merchant Ave. 040 L 2956u' 1:0 L 10001381: 94 L96 2059 2u' Bankoffterica. 12979 INNACLE ���� STTE CONTRACTORS, LLC 5-13/110 10/18/2007 . P. O. Box 1 I01 Sagamor a Beach. MA 02562 PAY TO THE ORDER OF Commonwealth of MA '•300.00 Three Hundred and 00/100""'••"""""'"'•" " """'••'•••"••"""*'• DOL ARS Commonwealth of MA P. O. Box 7070 Boston, MA 02204 MEMO 158MerchantAve. Gi,rb,,�•("^b BOO 1297942 1:0110001381: 94196 20592U' PINNACLE SITE CONTRACTORS, LLC 12979 • THE COMMONWEALTH OF MASSACHUSETTS Board of Building Regulations and Standards Home Improvement Contractor Registration One Ashburton Place, Room 1301 Boston, MA 02108 Application for Registration as a Home Improvement Contractor or Sub - Contractor MGL c.142A; 780 CMR R6 For DPS Use Only. Registration No: Effective Date: Expiration Date: Date Processed: LDusuimmAu PinnaL�f $i}G �orlradnr5 (►_G APPLJCANTPIIONE:: �oS� �K3�Dq 2. htAamcADDRrss: R0. *f( 1101 Mode k0A MA n'LSL�2 STREET CRY STATE zw 3. PERMANENT ADDRESS (IF'DIFILIIYMT): 33 Coy%,mcf Ave-Riyugps &Y MA 0a?532 STREET CRY STATE UP (PLEASE NOTE THATA P.O. BOX IS NOTACCEPUBLE FOR PERMANENT ADDRESS) 4.APPUCANrTYPE (cmwxoNE):_INDIVIDUAL_D/WA _PARTNERSHIP nusT _PRIVATE CORP. _PUBLICCORP. _I.I..P. X LLC. (SEE DI mucriam REGARDING THE E?,KXOSURE OF ACITY OR TOWN REGISTRATION CERTIFICATE IF D/B/A IS CECSEDi.) S. SOCIAL SECURITY OR FEDERAL TAX I.D. NUMBER: D Ii 3 L f 2102 s Nu.ERER of E,QLDYEEs / 9 7. HAVE YOU REGISTERED PREVIOUSLY UNDER THIS I.Aw 7 YLS X NO IF YES, PLEASE PROVIDE THE NAME AND REGISTRATION NUMBER IN WHICH YOU WERE PREVIOUSLY REGISTERED: NAMM REGISTRATION NUMBEa _.-.-.__. _ a.A) ARE YOU CURRENTLY OR HAVE YOU EVER REEK AN OFFICER, PARTNER, OR CO -VENTURER OF AN APPLICANT WHO PREVIOUSLYAPPIIED FOR REGISTRATION L 4DU THIS LAW (n1." C.142A)? YES x NO R) IF YES, PLEASE PROVIDE THE NAME OF THE APPLICANT AND NAME OF THE BUSINESS (IF DIFET:RM) AND REGISTRATION NU► BEW APPUCANT/RUSINESS NARY: RES-FR•TIONNUMBER: - -' 9. A) ARC YOU CURRENTLY OR HAVE YOU PREVIOUSLY BEEN EMPLOYED BYA REGISTRANT OR APPLICANT FOR REGISTMTION AGAWST NHICH DISLTPUNARY ACTION WAS TAKEN BY THIS DEPARTMENT? YES XC No Do NoT KNow B) IF YES, PLEASE PROVIDE THE NAME OF THE INDIVIDUAL AND BUSINTSS (IF DIFFERENT) AND REGISTRATION NUMER: APPLICANT/&I;MLSS N,Ua% REGISTRATION NUMBER: IL PLEASE PROVIDE THY NAME, SOCIAL SELURnT NUMBER, AND TITLE OF THE INDIVIDUAL IN THE CCRRENT BUSLYESS THAT IS RESPONSIBLE FOR THE OVERSIGHT OF HOME IMPROVEMENT CONTRACTS: %r FIRST SOCIAL SECURITY F TITLE It. DOES PPLXANT OR RESPONSIBLE AINDIVIDUAL HOLD ANY OTHER CONSIRUCr1ON-RELATED STATE, CRY OR TOWN LICENSES OR REGISTRATIONS? YFS NO RYES, PLEASE FILL IN INFORMATION BELOW. ATTACH ADDmoNAL SHEETS IF NECESSARY. LICENSE TYPE ISSUED BY I.C*rNSEJREC.N EXPIRATION DATE LICENSE HOLDER NAME I,c{'al $�)pwVl I s CS 804510 Z lz%Zoo9 Kobe 6 11011E IL LIST ALL PARTmjts, TRUSTEES, omaw6 DIRECTORS, AND MAJOR OWNERS (10% OR GREATER OF OWNERSHIP) OFAN APPLICANT PARTNERSHIP OR CORPORATION. BELOW. USE ADDITIONAL PAPER IF NECESSARY AND INCLUDE NEEDED PAPERWORK (SEE INSTRUCTIONS). PLEASE INDICATE BY AN "X" W TILE LAST COLUMN Tf105E INDtITDUAIS SITIO REQUIRE AN APPLJCATION FOR ADDITIONAL REGISTRATION S.D.CARDS. USE ADDITIONAL SHEETS IF NECESSARY FtLLNAAjE - TITTLE */GONNE ADDRESS OwmI &.!: Dww � ° ao She h-4rd Rd S Mw ef"V b aalan wnCi Uv 1 5*/ 8Y Na,-Af Rd ,i AHoRt �Cr A Mft • 13ir1S THEAPPLICANT MINING AN ESUWrION FROM THE YECLSIRATION FEE ASACSLHOLDERS YES /L NO K RccuTRATION FEE ENCLOSED: S IOO CLmAm FUND FEE ENa osED: S l OD PLEASE INCLUDE TWO SEPARATE CERTIFIED CHECKS OR MONEY ORDERS.ONE HARM ^REGISTRATION FEE" AND ONE MARKED*GUARANTY M.D." h1AKE CHECKS PAYABLE TO *COMHONRTALTH OF bL%UACHUSMI." CIROCS WI L BE PROCESSED RUT WILLTAYE AN ADDITIONAL TEN (10) DAYS. PURSUANT TO bLGI- C.62C. ¢49A,1 HEREBY CERTIFY UNDER THE PAINS AND F'EKALTIFS OF PERIURYTHAT 1. TO THE BEST OF MY IONOVITZGE AND UNDERSTANDING HAVE FH.ID ALLSTATE TAX RETURNS 1 FURTHER CERTIFY THAT THE INFOR-MATION CONTAINED ON THL4 APPLICATION IS A TRUE AND ACCURATE STATEMENT. I OW col g,b u) Old KinWs Highway Regional historic District Committee in the Town of Yarmouth for a CERTIFICATE OF APPROPRIATENESS APPlication is hcrehY made m triplicate,*for the issuance of a Cetti6r de of Apptopriataoess under Section 6 of Chapter 470, Acts and Resolves of MassadmsetM 1973, for proposed work as described below and an pbn-% drawings or p1t0togiaphs amompanymg this application for: CHECK CATEGORIES THAT APPLY: 1. EtdedorBuilding Ccattructkn- Q New Building ladratetypeoft■ I&V 0 ilouae Cl Gunge Q Addition p Altemtm 13 Comm=ml O OtLa 8 �, —I D 2 Exterior Punting: [3 _ 7 ]3 3. Signs or BaMmrdc (3 New Sign p Egg Sign 13 Rep/amltmg existing sign n C3 '� o 4. strucha¢ [3 Fence Wall13 ibgpole 13 Othrr��t ► d ► Ar �` m — rrraoxrQcrrcmmY DATE February 7,200077 y ADDRESS OF PROPOSED WORK 158 Merchant Ave. ASSESSORSMAPNO 127 OWNER Robert & Doreen Oberg ASSESSORS LOT NQ 2 4 HOMEADDRESS 158 Merchant Ave.,Yarmouthport TEI.EPHONENO. Robert B. Dunphy _ AGENT OR Dublin Construction,Inc. TF�LFP1iONENO 430-4700 ADDRESS 218 Blue Rock. Road,South YarmotithMa. 02664- USE ATTACHED SHEET IN PACMff FOR A13UrnXG OWNERS DETAQ.ED DESCREMON OF PROPOSED WORK: Give all prtkulars of work to be done including matamb to be used. in cam of signs, give locaticm of casting signs and proposed locmioas of new signs (Attach additiood sbcct, if } Build retaining wall --and add the necessary fill in order to.widen driveway in Accordance to attached plan NA 0 8 2007 V4' YAttr,1UUTH�BnG OwnerCootractor,P )elowlmcfor Committmuse only. OI-O KIN;•- HIGHWAY Kmaved by OKHC Da i 'D chak r r_ J APPROVED O DH'ORTANT. If Cafifimt- is approved, appoval is subject to the 10 day aPP� paW provided is the Act MUPPROVED 13 Pkase to- Yarmouth ORHC District Committee Yarmouth Town Hall, 1146 Route 28, S. Yarmouth, MA 02664 10/05/2007 09:54 5087717163 MCUDILO PE PAGE 02 8.3 degrees �T'$F"yG'�'' 14.0 F ft 14.33 t _7 5 4 6 3 Type 3 DPe- OPT ' PP rDl-YHA '—AL:L_ Y PP Se03Y Lheti - Z " 3 PP geo3ynthetic ��r�L� Mwu►�a>c: i PP geosynthatle 2.0 ft 2 9eo3ynthetic -0 5 ft j ItL W� p �i'�1 Wji 30` ►[ Z PP geezYt>ece- 5 t arty: 12.0 ft- MICHELE c. TUDOrj No. 34774 STRUCTURAL 0 l Y-��t�F�� : Mt{c� 4vAvr� ec TrP� �• `\r f Irt r-t L 5' UN:'��rt'�•,UC`!1"'1415A1 ii,4,i L_ tj IOtI0LT. STFtC}�CtT r{ %pO II'T. Pc!-FnK-AI-P p;ati- XWA.4 ,u r-1.LL. 1"�Al(. {3Tk, ''f-�tYY✓<�J-1 --t ,..., JtILETAINING I I T v T"r., iii ii .lilt.i .Si; 1 TT[i .T. .-. •� .: _._....: i '� EEZNN Old King's ffiighway Regional Historic District Committee in the Town of Yarmouth for a CERTIFICATE OF APPROPRIATENESS Application is hereby made in triplicate, for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470, Acts and Resolves of Massachusetts, 1973, for proposed work as described below and on plans, drawings or photographs accompanying this application for. CHECK CATEGORIES THAT APPLY: 1. Exterior Building Construction: p New Building 0 Addition 0 Alteration ^� MOW Pipeofbuilding 0 House 0 GuW 0 Commercial 0 Other 8 —� 2. Exterior Painting 0 `^J `� D �7 3. Signs or Billboards p New Sign 0 t � Existing Sign 0 Repainting existing sign _ r ("j'j co 4. Shucu= 0 Fence Wall p Flagpole 0 Other�TR / A< / N f1J `7 r— e _ T1TE OR PRLYI LEGIBLY DATE February 7 , 2 0 3 ry ADDRESS OF PROPOSED WORK 158 Merchant Ave. ASSESSORS MAP NO 12 7 Robert & Doreen Oberg 24 OWNER ASSESSORS LOT NO. HOMEADDRESS 158 Merchant Ave.,YarmouthRort TELEPHONE NO. Robert B. Dunphy AGENT OR CONTRACTOR Dublin Construction, Inc. Tq.EPHONENO 430-4700 ADDRESS 218 Blue Rock. Road South Yarmouth,Ma. 02664 _- USE AITACHED SHEET IN PACKET FOR ABUTTING OWNERS DETAILED DESCREMON OF PROPOSED WORK Give all particulars of work to be done including materials to be used In case of signs, give locations of existing signs and proposed locations of new signs. (Attach additional sheet, if n0C`w')' Build retaining wall•• -arid add 'the necessary fill in order towidendriveway in accordance to attached plan Data• -�'-a Check # APPROVED APPROVED MAR 0 8 2007 _,.. YARMOUTH O IMPORTANT: If Certificate is approval, approval is subject to the 10 day appeal period provided in the Act DISAPPROVED 0 Please return to: Yarmouth OKHC District Committee Yarmouth Town Hall, 1146 Route 28, S. Yarmouth, MA 02664 I �O AMENIDMEM CIA # DATE sn —0� t ADDRESS 11' 2. 3. 4. I agree to the above conditions - Owner! ORH/C haird SignatZ416r� Signature APPROVED MAR 08 2007 I YARMOUTH OLD KING'S HIGHWAY DUBLIN CONSTRUCTION INC. 541 Main Street Harwich, MA 02645 Phone:508-430-4700 Fax:508-432-4701 October 13,2004 Mr. James Brandolini Building Commissioner Town of Yarmouth Yarmouth,Mass. 02664 Dear Jim: OCT 131004 UUiL�7 /, G=ij1. Pursuant to our conversation regarding 158 Merchant Ave., Yarmouthport I will within the next thirty days enhance the driveway embankment at this house with a boulder rip -rap wall. PKM excavation has been contacted to do this work and will see that it is finished within the thirty day period. Thank you for your consideration in this matter and please contact me if you require any additional information. ail OLD E ING'S HIGHWAY REGIONAL HISTORIC DISTRICT COMMITTEE eapie IN THE TOWN OF YARMOUTH CERTIFICATE OF EXEMPTION Application is hereby made for the issuance of a Certificate of Exemption under Section 6 and 7 of Chapter 470, Acts and Resolves of Massachusetts, 1973, as amended for proposed work as described below and on plans, drawings, or photographs accompanying this application. ' TYPE OR PRINT LEGIBLY DATE HOME ADI AGENT OR ASSESSORS MAP # ASSESSORS LOT # TELEPHONE # g ADDRESS v TELEPHONE# —�% — O J> THIS APPLICATION IS FOR EXEMPTION OF PROPOSED EXTERIOR CONSTRUCTION ON IW GROUNDS THAT: ( ) IT WILL NOT BE VISIBLE FROM ANY WAY OR PUBLIC PLACE. #Ir IT IS WITHIN A CATEGORY DECLARED ENTITLED TO EXEMPTION BY OLD KINGS HIGHWAY REGIONAL HISTORIC DISTRICT COMMISSION. (Check applicable box) PROPOSED WORK: DESCRIBE WORK, SHOWING LOCATION ON LOT, AND, IF AN ADDITION IS INVOLVED, S LQCAI 1$ EXISTING BUILDING. lL AVWWI ���� fi ner - Contractor - ,cc below for Committee Use. Received by OKHC The certificate is Date 6-r' -Q eir— cnuldR_,�Lj�l4�� By Di APPROVED ) DENIED ( ) U T -?r eP4Ro�� .,�uRO OF October 12, 2004 A Mr. Dunphy 158 Merchant Ave. Yarmouthport, MA 02675 Re: 158 Merchant Ave. Dear Mr. Dunphy It has come to the Old King's Highway Committee's attention that you have installed a new fence without a Certificate of Appropriateness. Any changes made to the properties in the Old King's Highway Historic District are subject to prior approval. For your convenience I have enclosed the application. Please return the application to me as so as possible. -- - Thank you in advance for your cooperation. O Sincerely, —`� n-I t Maryclare Troiano Secretary me 10/12/04 Note: Mr. Dunphy came in and spoke with Deb in reference to being cleared through the v Building Dept. (Landscaping done and fence will be painted, needs a picture) Mr. Dunphy will do a Cert. of Exemption. prPr;r:F;; l f Ks r J. .a' !"• -vi. z r ti- ♦ J t� R t •i..Y i*i -r ;; y , s •a �•4 , �!F-- a �'4.« 5 -�i� `_- i y � _ $ '- X,Y - �,F ,. .a r ,.....�--•^_"t , f � J ;+�. �efd ��. �' � a&.4 �, s N f ���.f•�� J^'4� ,Jj _ - s [• �� "�.1 ' 1.54 `�; t• •ec �'`-� i' '•' � `.: ` t . , . i, r � .y,r` t r 5 - s * � ; - �.-..� �.— - l r � s � r "^ '� c-,►�s , x 4 }�-.: t.rl � .�,r .:t�s t� s < ,+�, _ �k{ 'ii�`� y ,«, t�ja �.r.� . >•' -.,� �• � � < 4A . + �Y; a .Y '�' "w�a 'r '� i'� • -r-•5 ,�,j+x`F�,,....�°I �±tie•tlya f. s�+�a x'°..'O`,I. • i y+ ay -�lJ- . _ �! E�' �� lam. ji ����S t ae� > -. < t tf•!f' ./ \ a .'r ,�� Jr, �V�Rrtiti.-f� L [ vX P j Ts as 'F \ "�ja:s `.k° +rt\ f%.. ^•." 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I r �.s� _ - SW.�r. N ..re- !r4 ,a'.f'•ca�'¢e� � �, y dIX • 1• r ��Y ++. .—._,mod � '<'v.,w..- �". .,.c.. •_. _ ,. i... ' � V}� . _ _. i V 4:' 111 N r .0 APPROVED YARr„OUTH O04!1,111TEE DARNSTAS "MST, Old King's Highway Regional Historic District Committee i in the Town of Yarmouth for a CERIMCATE OF APPROPRIATENESS Application is hereby made in triplicate, for the issuance of a Certificate of of Chapter 470, Acts and Resolves of Massachusetts 1973 for Aork as were s under Station 6 plans, drawings or photographs accompanyingProposed work as described below and an � application for. CHECK CATEGORIES THAT APPLYL--A I. Ex-teriorBuilding Construction : p New Building 13 Addition p Alterati03 MAR 13 AM 9:31 hIdIQ a type ofWLIding 13 House p Garage p Commercial p Other 2. Exterior Painting p 3. Signs or Billboards 0 New Sign ❑ Existing Sign p Repitng adsting sign 4. Stricture: l3 Fence p Wall p Flagpole p Other TYPE OR PRL\T LEGIBLY DATE Jan r a v 2 2003 ADDRESS OF PROPOSED WORK Lot 46, �6%Merchant Ave ASSESSORS MAPNO. 127 OWNER Lola Abt 5049 Kensington High Street ASSESSORSLOT No. 24 HOME ADDRESS�� 7 p K� o-- H e m s TELEPHONE NO. AGENT OR CONTRACTOR Robert Dunphy TELEPHONE NO 760-1318 ADDRESS 218 Blue Rock Road, South Yarmouth,Ma. 02664 USE ATTACHED SHEET IN PACKET FOR ABUTnNG OWNERS DETAILED DESCRWnON OF PROPOSED WORK Give all particulars of work to be be used. In case of signs, give locations of casting sips and proposed locations done including materials to of signs (Attach additional sheet, if yl Construction of a new four bedroom Cape style house with a two car attached garage and a rear screened porch and deck. Received Cheek t< 4 By --Pt_ APPROVED APPROVED YAIRbIIOUTH COMM11 is h (r Fc� c-�' 4ate /a 03 O IMPORTANT. If Certificate is approved, oppro%W is subject to the 10 day appeal period provided in the Act. DISAPPROVED E3 Please return to: Yarmouth OKHC District Committee Yarmouth ToR71 Hall, 1146 Route 28, S. Yarmouth, MA 02664 DATE 3- 1a-C73 - does hod- s�oca� I. row i In� c h 50grck e. ��dr - 2. rj-,UF J.O'k.�-P-� +raKsov� 3 4. I agree to the above conditions - GA# 3-►0IS" f- t S e aver Rer/Ag OKH/Chairman ignature Signature pinefs �0.t,Q5e door e03 MAR 13 Am 9:32 TOWN OF YARMOUTH 1146 ROUTE 28 SOUTH YARMOUTH MASSACHUSETTS 026641I451 Telephone (508) 398-2231, Ext. 292 — Fax (508) 398-0836 OLD KING'S HIGHWAY REGIONAL HISTORIC DISTRICT COMMITTEE e103 MAR 13 m 9:32 STATEMENT OF UNDERSTANDING As property owner/contractor/agent for construction at: l a_�o 3 In accordance with the Guidelines to the Act, `Sec. E.1., only minor changes may be approved by the Committee without the filing of a new application and a new hearing. Minor changes or alterations would include such matters as altering a single window or door change or a minor change of colors which could be made without a detrimental impact to the overall appearance of the project. All alterations by amendment or otherwise will require the local Committee's approval." Before or after work has begun on a project approved by the Old King's Highway Committee, a request for a minor change must be submitted to the committee in writing. Approval shall be obtained before incorporating the change into the . project. For more than one revision to previously approved plans, a new Certificate of Appropriateness must be filed and approval voted by the committee before incorporating the changes into the project. Failure to do so will result in the Building Department issuing a Stop Work Order or delaying issuance of an Occupancy Permit or final inspection approval. Filing a Certificate of Appropriateness for revised plans, after work on the changes has been started or completed, will also result in having to pay a filing fee of $50.00. I have read and understand the above statements. 03 Signed: Date: 3 n r/Contracto Ag t Signed: Chair., Old I ( g' ighway Committee V1 Printed on Recycled Paper SPECIFICATION SHEET (YARMOUTH OKHC) - SUBMIT 3 COPIES Lola Abt, Merchant Ave. NAME OF OWNER(S):. ' 'FOUNDATION .(IrMAX. EXPOSED): 12" exposed CONCRETE STEPS (INDICA BRIC EMENT/OTHER) Brick SIDING TYPE: Red cedar clapboards on front White.cedar shingles on sides & rear CHIMNEY (INDICATE BRICK/STUCC(OODFACED) N/A i.{/ Montgomery White COLOR: J '()3 MAR 13 Ag 9:32 G ROOF MATERIAL: Asphalt PITCH (7/12 MIN.) COLOR: MAX. ENP. 4" Weatherwood WINDOWS (GRILLES REQUIRED) -INDICATE SIZES IF NOT LISTED ON ELEVATIONS: Andersen tilt wash with grills per plan DOORS (INDICATE SIZES IF NOT LISTED ON ELEVATIONS): Steel six panel and fifteen light per plan TRIM: (ALL WINDOWS & DOORS TRIMMED WITH 1X4 / 1X5 WOOD) Ix4 SHUTTERS (WOO ANELE GUTTERS (WOO ALUMINUM): - - - GARAGE DOORS: SIZE & STYLE:_ Steel / Raised panel STORM WINDOWS & DOORS: (INDICATE SIZES IF NOT LISTED ON ELVATIONS) SKYLIGHTS: TYPE/SIZE: A9 3 ):�'C4-7r , r- l n-T-oNz: DECK. SIZE & MATERIAL: P.T. material FENCING (MAX. HEIGHT fl: STYLE: (SHOW LAYOUT & RUNNING FOOTAGE ON SITE PLAN) RETAIN NG WALL: (P.T. OR FIELDSTONE. -CONCRETE INAPPROPRIATE) (SHOW LAYOUT & RUNNING FOOTAGE ON SITE PLANIOPP*4, ADDITIONAL INFORMA COLOR: Lafatette Green COLOR: White COLOR: Lafayette Green COLOR: White. COLOR: White COLOR: COLOR: COLOR: COLOR: I IIMontgomeryl � �{ayettel NOTES: ATTACH COLOR CHIPS. INDICATE LANDSCAPING, EXTERIOR LIGHTING & ELECTRIC METER ON SITE PLANS FOR NEW HOUSES. APPROVED REV. 5/98 YAR14OUTH COMMIHE;, Oan I&I .. �btiER '- LOAM :ANU utU 40 SCHEDULE 40 • PVC PIPE MIN. PITCH 1/8• PER-FT.34.1 _ 2" 5m 4• CAST IRON PIPE YA)C 31 PITCH EQUAL) /4 i PERMUFT� Tim FLOW LINE 31.00 ELEV. 3&50 to• J =;tiuN. V. 31.50 - -2.0. • • 1 VEL ► a r� - _ ELEV. - 33i.7 _ BAFFLE E . ELEV. 6 SUMP may, :; � 5 DISTRIBUTION ELEV. • LIQUID OUTLET B>•/X a .��1 CAPACITY INFILTRATORS; QFPTH TEE (TO BE PLACED ON FIRM, BASE) "'�'�- STONE IN AN: 4 •FEET 14 INCHES TO BE,WATER TESTED 5 FEET 19 INCHES - IF -MORE :THAN ONE -OUTLET -11 % 48':�( 10•- TRENCH'FORht 6 FEET 24 INCHES 15D0..GALLO TO BE PLACED ON FIRM SASE) 7 FEET 29 INCHES p77 c _ SOIL ABSORPTION 8 FEET 34 INCHES SEPTIC IT AN 3/4- T I lji ,DOUBLE STONE S1rsTEM (sash FREE OF FINES Ic SILT usos PROB(�BLE WATER.TAt SEWAGE DISPOSAL SYSTEM PROFILE OBSERVED WATER TABLE (• ::v NOT 'TO SCALE BOTTOM: OF ST�F r i / r• 'y / i VVV � ,•� 1 /LIMIT .0 SOIL . /� . / 3 5' 0 IG TEST or SOIL / sr F/�G LOT 46 TEST �' : r `!/ A)?EA 18682f SF. If r T1C 2.2 M P�tirwaxx+• I Y ( i L11YIA7M• A.JtY e 1 . / V) / /41.P -I Z z os r TOWN OF YARMOUTH Building Department BUILDING d!� - _ _ - _ - - - - (508) 398-2231 ext.261 PERMIT NO B-03-1194-' PERMIT .. ISSUE DATE 6/20/03 • • ; PROPOSED USE APPLICANT : Lola Abi-------••--••--•------•- JOB WEATHER CARD ADDRESS ;5049 Kensington High Street PERMIT TO ' New Construction ; -------- ----- -----------' ----- ------ AT (LOCATION) 1001158MERCHANTAVE ZONING DISTRICT R-40 SUBDIVISION MAP LOT BLOC 1127.24 BUILDING IS TO BE USE GROUP R-4 LOT SIZE I CONST TYPE 5-8 CONTR'S 069294 new construction: 2.5 baths, 4 bedrooms, 1 open deck,lden,t diningroom, tfamilyroom, lgas REMARK log fireplace, one- two bay garage,I kitchen, 1 laundry, 2 open porches, 1 storage area as per plans dated 04/29/03. AREA (SO FT) EST COST ($ $235,392.00 PERMIT FEE OWNE LolaAbt ADDRESS 15049 Kensington High Street BUILDING DEPT BY INSPECTION RECORD LICENSE CONTR'S NAM Dunphy, Robert FIELD COPY Date I Note Progress - Corrections and Remarks I Inspector of r TOWN OF YARMOUTH Building Department BUILDING (508) 398-2231 ext.261 ►- PERMIT NO B-03-1194- ;� ISSUE DATE 6/20103 - - ; PROPOSED USE PERMIT APPLICANT 'Lola abt . " ....... - - " " " . .. " " .. JOB WEATHER CARD ADDRESS :5049 Kensington High Street PERMIT TO ; New Construction ' ---- -------------------- - - -- ---- AT (LOCATION) ZONING DISTRICT SUBDIVISION MAP LOT BLOC [127.24 BUILDING IS TO BE USE GROUP R-4 LOT SIZE CONST TYPE 5•B CONTR'S LICENSE 069294 new construction: 2.5 baths, 4 bedrooms, 1 open deck,lden,l diningroom, tfamilyroom, 1 gas CONTR'S NAM REMARK log fireplace, one- two bay garage,t kitchen, I laundry, 2 open porches, 1 storage area as per plans dated 04129/03. 10unphy, Robert AREA (SO FT) EST COST ($ $235,392.00 PERMIT FEE OWNE Lola Abt ADDRESS 15049 Kensington High Street BUILDING DEPT BY Certificate Issue Date _; .CERITIFCpTE of OCCUPANCY Departmental Approval for Certificate of Occupancy and Compliance Inspector I Date I Permit Number I Approved By I Remarks BUILDING PLUMBING/GA ELECTRICAL ENGINEERING OTHER To be filled In by each division Indicated hereon upon Inspection. os TOWN OF YARMOUTH Building Department BUILDING �! _ _ _ _ _ • (508) 398-2231 ext.261 PERMIT NO 8-03-1194- PERMIT N ISSUE DATE 6/20/03 - - : PROPOSED USE _ _ _ . _ _ _ APPLICANT :Laa'Abi " " " ' " " " " " " " " " JOB WEATHER CARD ADDRESS :5049 Kensington High Street PERMIT TO : New Construction ' . -- ......... ....... ------- ----' AT (LOCATION) 100158MERCHANTAVE ZONING DISTRICT fl-40 II SUBDIVISION MAP LOT BLOC 1127.24 BUILDING IS TO BE USE GROUP R-4 LOT SIZE CONSTTYPE 5•B CONTR'S LICENSEI 069294 new suction: 2.5 baths, 4 bedrooms,, open deck.1de diningroom, Ifamilyroom, lgas CONTR'S NAM REMARK log firepla , one two bay garage, kitchen, 1 laundry, pen porches, , storage area as per plans dated lWj 03. 1 Dunphy, Robert AREA (SO FT) OWNE Lola Abt ADDRESS THIS PERMIT CONVEYS NO ENCROACHMENTS ON PUB STREET OR ALLEY GRADE: THE ISSUANCE OF THIS PE EST COST ( 235,392.00 PERMIT FEE ($) $1,080.00 Street BUILDING DEPT BY I ANY STREET, ALLEY OR OT SPECIFICALLY PERMIT' :PTH AND LOCATION OF PU RELEASE THE APPLICANT MINIMUM INSPECT NS OUIRED FOR ALL / CONSTRUCTION - 1) FOUNDATIONS OR FOOTINGS. 2) P O O COVERING STRUCTURAL MEMBERS (REA Y OR LATH OR FINISH COVERING) 3) AL INSPECTION BEFORE OCCUPANCY 4) REFER TO DETAILED INSPECTION SCHEDULE IS CARD SID AUC OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY. D R THE BUILDING CODE, MUST BE APPROVED BY THE JURISDICTION. C ERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLUC WORKS. RO T CONDITIONS OF ANY APPL ABLE SUBDIVISION RESTRICTIONS. A ROVED PLANS MUS/BEENE. ED ON WHERE APPLICABLE OB AND THIS CARD KEUNTIL PAR PERMITS ARE FINAL INSPECTION HAS R UIRED FOR ELECTRICAL WHERE A CERTIFICATE NCY IS PL ING/GAS AND REQUIRED, SUCH BUILDOT MEC ANICAL INSTALLATIONS. OCCUPIED UNTIL FINAL BEENMADE.------ - -- 2 2 / 2 3 OTHER 11,2 3 4 b WORK SHALL NOT PROCEED PERMIT WILL BECOME NULL AND VOID IF INSPECTORS INDICATED ON THIS CARD UNTIL THE INSPECTOR HAS CONSTRUCTION WORK IS NOT STARTED WITHIN SIX CAN BE ARRANGED FOR BY TELEPHONE APPROVED THE VARIOUS MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED OR WRITTEN NOTIFICATION. STAGES OF CONSTRUCTION ABOVE. • ` oQ� •YgR�T •!� 0 0 c O ONE & TWO FAMILY ONLY - BUILDING PERMIT APPLICATION TO CONSTRUCT, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING Town of Yarmouth Building Department 1146 Route 28 + Yarmouth, MA 02664-4492 FAX Tel: (508) 398-2231 x261 • Fax: (508) 398-2365 /` - ._ Office U$a Only _",':' 1 Perrnit No Date Perirllt Fee $;1. Y„- u�'�n Deposit Rec'd $Q'.te "i'�� 'Net Due-',!_!..:$ ,Q3(};. '� Planning Board Information lanpri T y Endorsement Date RecordiOate ng ? Plan No '' er Assessors Department.fnformation Map cor Old , New 1.4 Propeity Dimensions " '.Lo Area so :=Frontage(tt) LoCCoverage , Section for Office: Use , Only BuildingRe it umber. Date.1ssued:' ` signature...,4 ' :Building 'Official. , Date', .,:5 Certificate Occupancy t , Is Is not' requlrAd_ Section if ="Site Information Use Group: R-4 Type: 5-13 1.1 Property Address: 1.2 15g Merchant Ave. Zoning Information: rJ YO Zoning District Proposed Use Yarmouthport,Ma. 02675 1.3 Bullding Setbacks (ft) Front Yard de Yards Rear Yard Require Pro ided Re ed Provided Required Provided 30'._.." . _ _._ _.3 r _ _... _. 5 r — ' 45' &- 25' +- - 20' 41 .87' 1.4 Watot Supply (RLO.L c 40.S54) Public Private/ Flood Zone, Infonmatlon « r ,^ " i, . : Comments i� `;> n .,;Zone:,i`. BFE. ' Section 2"=�[ Pro ertyAw er6 p/Authorized A nt 2.1 Owner of Record: ' Lola Abt sI Name (print) S gnature /jalljingArddre elephon 2.2 Authorized Agent: Robe u 218 B1 Rock Rd. N e (prin Mailing Address �to-: South Yarmouth,Ma. 02664 Sig a ephon ection.3.'4 Construction S ices: 3.1 Licensed Construction Supervisor. I D� I, t� U II IVI Robert Dunphy otApplicable ❑ (Same) AIR 0 2 u Ucense umber 069294 Address Expiration Date Signat T6Whone 3.2 gistered lHomelm rovementr'Contract 'r C056pany Daame 3 2 Not Applicable ❑ License Number Address f ' ; ( V' t s F Signature Teleph Expiration Date 7- 1 . QQ 1 of 9 M ro The Commonwealth of Massachusetts _ Department of Industrial accidents OJAca of/crvcstl®ado®s 600 Washington Street Boston, Mass. 02111 Workers' Compensation Insurance Affidavit Applicant in fgrm a ilon: PleaieiPRiIVTTk�+Gb11r namz Dublin Construction,Tnr Iocntoon* 158 Merchant Ave - Yarmouthport phone# 760-1318 1 am a homeowner performing all work myself. O 1 am a sole proprietor and have no one working in any capacity 0 lam an emplover pro%iding workers' compensation for my employees working on this job. insurince Co. policy # 0 1 am a sole proprietor. general contractor. or homeowner (circle one) and have hired the contractors listed below who have the follow•ine workers' Compensation polices:. .` 218 Blue Rock Road tl1Y South Yarmouth phone a: 760-1318 , ens Traveler' policy 6KUB-907x277907 Failure to secure coverage as required under Section 25A of MGL 152 can lad to the imposition of erimiaal peaaltln ofa Doc up to st.SUIt.UY and/or one years' imprisonment as well as Civil penalties in the form of a STOP WORK ORDER and a lice of sioo oo a day against me. I understand that ■ copy of this statement may be forwarded to the Office of investigations of the DIA for coverage verificadoa. / do hereby cerl' �un r the paint and pe alties ojp 'urythat the info motion provided above is true and eorre/^df. Signature /Vr ate Print name Z Phone 0 r/ z�/= it ,, /! () r official use only do not write in this area to be completed by city or town official city or town: YARHOUTIi ❑ check if Immediate response is required permittlicense # -Building Department ❑Licensing Board 261 ❑Selectmen's Office ❑Health Deportment fKn0% 398,2231 ext contact person: phone #: _ _ -Other • .2 o�R • TOWN .OF YARIVIOUTH BUILDING DEPARTMENT CONSTRUCTION' SUPERVISOR FORM PLEASE PRINT: Job -Location: 1 58 'Merchant 'Ave•. Yarmouthport Number : Strcet Village Owner of Property: Lola Abt . Construction Supervisor: Robert .Dunphy 069294 760-1 318 Name License No. Phone No. Address•218 Blue Rock Road,' South Yarmouth,Ma. 02664 Licensed Designee: (If other than Supervisor) Name 2.15 Responsibility of each license holder: License No. 2.15.1 The license holder shall be fully and completely responsible for all work for which he is supervising. He shall be responsible for seeing that all work is done pursuant to the state building code and the drawings as approved by the building official. 2.15.2 The license holder.;shall be responsible.to supervise the construction, reconstruction, alteration, repair, removal or demolition involving the structural elements of building and structures only pursuant to the state building code.and.all.otlie.r applicable,la�vs of the commonwealth, even though he, the license ..holder, is not the permit holder but only a subcontractor or contractor to the permit holder. 2.15.3 The license holder shall immediately notify the building official in writing of the discovery of any violations which are covered by the building permit. 2.15.4 Any licensee who shall willfully violate subsections 2.15.1, 2.15.2 or 2.15.3 or any other section of these rules and regulations and any procedures,'as amended, shall be subject to revocation or suspension of license by the board. 2.16 All building permit applications shall contain the name, signature and license number of the construction supervisor who is to supervise those persons engaged in construction, reconstruction, alteration, repair, removal of demolition as regulated by section 109.1.1 of the code and these rules and regulations. In the event that such licensee is no longer supervising said persons, the work shall immediately cease until a successor license holder is substituted on the records of the building department. 2.17 The license holder shall be responsible for requesting all required inspections. Failure to do so may be deemed a violation of the permit conditions. I have read and understand my responsibilities under the rules and regulations for licensing construction supervisors in accordance with* .Section 109.1.1:of the state building code. I understand the construction inspection procedures and:tlie specific inspection as called for by the building official. INSURANCE COVERAGE: .. I have a curre liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.152 Yes No ❑ If you have hecked m, please Indic a the type coverage by checking the appropriate box. A liability insurance policy CV Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE' Chaoter _6Nf the Mass. aware that the licensee does not have the insurance coverage required by 7that my �.gnature on this permit application waives this requirement. _ o /,r't Check one: Signatuo e re r wn or er's Agent Owner ❑ Agent � .n ,• err • , . J � TOWN OF YARMOUTH 1146ROUTE28 SOUTHYARMOUTH MASSACHUSETTS02664-4451 Telephone (508) 398-2231, ExL 261 — Fax (508) 398-2365 BUILDING DEPARTMENT DEMOLITION DEBRIS DISPOSAL AFFIDAVIT BUILDING ELECTRICAL GAS PLUMBING SIGNS Pursuant to M.G.L. Chapter 40, Section 54 and 780 CMR, Chapter 1, Section 111.5, I hereby certify that the debris resulting from the proposed work/demolition to be conducted at 158 Merchant Ave. Work Address is to be disposed of at the following location: S& J Disposal Dennis, Ma. Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Chapter 111, Section 150A. Signature of Applicant Date Permit No. MAScheck COMPLIANCE REPORT Massachusetts Energy Code MAScheck Software Version 2.01 Release 3 TITLE: Custom Cape - CITY: Yarmouth STATE: Massachusetts HDD: 6137 CONSTRUCTION TYPE: 1 HEATING SYSTEM TYPE: DATE: 3/20/03 DATE OF PLANS: PROJECT INFORMATION: or 2 Family, Detached Other (Non -Electric Resistance) 158 Merchant Avenue COMPANY INFORMATION: LIVING DESIGNS 131 QUAKER MEETINGHOUSE ROAD EAST SANDWICH, MA. 02537 1-508-888-2747 COMPLIANCE. Passes Maximum UA = 404 Your Home = 400 I I I I I Permit # I I I I I I Checked by Date Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Value U-Value . UA --------------------------------------------- CEILINGS 1344 30.0 0.0 47 WALLS: Wood Frame, 161' O.C. 1117 11.0 0.0 99 WALLS: Wood Frame, 16" O.C. 867 11.0 0.0 77 GLAZING: Windows or Doors 151 0.350 53 GLAZING: Windows or Doors 125 0.350 44 DOORS 52 0.3,30 17 FLOORS: Over Unconditioned Space 1344 19.0 0.0 63 NVAC EQUIPMENT: Boiler, 83.0 AFUE ------------------------------------------------------------------------------- COMPLIANCE STATEMENT: The proposed building design described here 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 131 d J4.4. Builder/Designer Date /c�? O TINE: Custom Cape MAScheck INSPECTION CHECKLIST Massachusetts Energy Code MAScheck Software Version 2.01 Release 3 DATE: Bldg.l Dept.l Use I I I CEILINGS: [ l 1 1. R-30 I Comments/Location I WALLS: [ ] I 1. Wood Frame, 16" O.C., R-11 I Comments/Location [ ] I 2. Wood Frame, 16" O.C., R-11 Comments/Location I WINDOWS AND GLASS DOORS: [ ) I 1. U-value: 0.35 I For windows without labeled U-values, describe features: I # Panes Frame Type Thermal Break? [ J Yes (] No I Comments/Location [ ] I 2. U-value: 0.35 I For windows without labeled U-values, describe features: 1 # Panes Frame Type Thermal Break? ( ] Yes [ ] No I Comments/Location I DOORS: [ ] I 1. U-value: 0.33 I Comments/Location 1 FLOORS: [ ] I 1. Over Unconditioned Space, R-19 I Comments/Location I HVAC EQUIPMENT: [ J 1 1. Boiler, 83.0 AFUE or higher I Make and Model Number I I AIR LEAKAGE: [ ] I Joints, penetrations, and all other such openings in the building I envelope that are sources of air leakage must be sealed. When I installed in the building envelope, recessed lighting fixtures I shall meet one of the following requirements: I 1. Type IC rated, manufactured with no penetrations between the I inside of the recessed fixture and ceiling cavity and sealed or I gasketed to prevent air leakage into the unconditioned space. I 2. Type IC rated, in accordance with Standard ASTM E 283, with no I more than 2.0 cfm (0.999 L/s) air movement from the the I conditioned space to the ceiling cavity.. The lighting fixture I shall have been tested at 75 PA or 1.57 lbs/ft2 pressure I difference and shall be labeled. I I VAPOR RETARDER: [ ] I Required on the warm -in -winter side of all mon-vented framed I ceilings, walls, and floors. I provided. Insulation R-values, glazing U-values, and heating 1 equipment efficiency must be clearly marked on the building plans 1 or specifications. I I DUCT INSULATION: J I Ducts shall be insulated per Table J4.4.7.1. I DUCT CONSTRUCTION: [ J I All accessible joints, seams, and connections of supply and return I ductwork located outside conditioned space, including stud bays or I joist cavities/spaces used to transport air, shall be sealed 1 using mastic and fibrous backing tape installed according to the I manufacturer's installation instructions. Mesh tape may be I omitted where gaps are less than 1/8 inch. Duct tape is not I permitted. The HVAC system must provide a means for balancing I air and water systems. I I TEMPERATURE CONTROLS: I ) I Thermostats are required for'each separate HVAC system. A manual I or automatic means to partially restrict or shut off the heating I and/or cooling input to each zone or floor shall be provided. I HVAC EQUIPMENT SIZING: ( J I Rated output capacity of the heating/cooling system is I not greater than 125% of the design load as specified I in Sections 780CMR 1310 and J4.4. I I SWIMMING POOLS: I J I All heated swimming pools must have an on/off heater switch and -- -- ---I--require -a cover_ unless over 20% of the heating energy is from I non-depletable sources. Pool- pumps_ require a- time- clock.---- I HVAC PIPING INSULATION: I 1 I HVAC piping conveying fluids above 120 F or chilled fluids I below 55 F must be insulated to the following levels (in.): PIPE SIZES (in.) I HEATING SYSTEMS: TEMP (F) 2" RUNOUTS 0-l" 1.25-2" 2.5-4" I Low pressure/temp. 201-250 1.0 1.5 1.5 2.0 I Low temperature 120-200 0.5 1.0 1.0 1.5 I Steam condensate any 1.0 1.0 1.5 2.0 I COOLING SYSTEMS: I Chilled water or 40-55 0.5 0.5 0.75 1.0 I refrigerant below 40 1.0 1.0 1.5 1.5 I I CIRCULATING HOT WATER SYSTEMS: ( 1 I Insulate circulating hot water pipes to the following levels (in.): I ' PIPE SIZES (in.) I NON -CIRCULATING I CIRCULATING MAINS 6 RUNOUTS I HEATED WATER TEMP (F): RUNOUTS 0-1" 1 0-1.25" 1.5-2.0" 2.0t" I 170-180 0.5 I 1.0 1.5 2.0 I 140-160 0.5 I 0.5 1.0 1.5 I 100-130 0.5 1 0.5 0.5 1.0 ----NOTES TO FIELD (Building Department Use Only)------------------------- PROPERTY ADDRESS: ALCULATION FOR PERMIT COST %!v yG `A G rz $ y J 0/7 X 1,r = 3 SG. — 9 3 6 _ �s I%rZ 51S1 — G/P ;LS, _ ILK Tor _ _ G` ---.. TYPE OF ROOM ETC NO ADDITION .;, ALTERATIONS BATH / y BED ROOM" CERTIFICATE OF OCCUPANCY COMPUTER ROOM DECK OPEN DECK WITH ROOF DEMOLITION DEN DINING ROOM / FAMILY ROOM FIREPLACE FOUNDATION ONLY--- . GARAGE NO. OF BAYS GREAT ROOM KITCHEN LAUNDRYROOM LAUNDRY ROOM LIVING ROOM MUD ROOM nPPIM: PORCH CLOSED PORCH OPEN a ;z X REROOFING SHED STORAGE AREA / SUN ROOM HEATED SUN ROOM UNHEATED SWIMMING POOL ABOVE GROU D SWIMMING POOL INGROUND WINDOW REPLACEMENT p�%7 TOWN OF YARMOUTH BUILDING DEPARTMENT 4 PLAN REVIEW & BUILDING PERMIT APPLICATION REVIEW NOTES ADDRESS: f Map / Lot: Date of Initial Review 11-17-� Other. Approval Date: Inspector. �j�4�%� NOTES: �c� -. ;sue ! �� �i i�i�i�i • /' s� RZE "umg vm= <u appucamey Section 1043.2, para. Change, Extension or Alteration (pre-existing, nonconforming) The proposed Other requires a Special Permit from the Zoning Board of Appeals. B Building Code Denial (if applicable) Rev.11-01 TOWN OF YARMOUTH Building Department Town Hall Yarmouth, MA 02664 (508) 398-2231 ext261 BBUILDING PERMIT APPLICATION RECEIPT Temp Permit No.: T-03-439 Applicant Name: Robert Dunphy Location: 00158 MERCHANT AVE Owner's Name: Lola Abt Owner's Addres 5049 Kensington High Street Naples FL 34105 Owner's Telephone: (OFFICE USE ONLY Recorded By: IC Permit Fee: $0.00 Deposit Rec: $50.00 Payment Type: Check ChkNo.: 6762 Net Owed: ($50.00) Application Date: 4/1 /03 Issue Date: Expiration Date Comments: �oi new construction: ZOPJINCr' APPROVED�� This is NOT a building permit. Application subject to plan review. Contact Building Department for permit status. Official Building Permit will be issued upon plan review completion, approval, and complete payment of Net Owed on Permit Fee. Date Printed: 4/10/03 /,05'g31 Building Site Location: Proposed Improvement: Address: A/ TOWN OF YARMOUTH BUILDING DEPARTMENT BUILDING PERMIT APPLICATION DEPARTMENTAL SIGN OFF TRANSMITTAL SHEET rs S�Tel.No.• Date No: The Building Department will be responsible for assisting the applicant by dispatching your plans and or application to the following applicable departments. RESIDENTIAL AND/OR COMMERCIAL BUILDING WATER DEPARTMENT: Determines Compliance of Water Availability and or existing location. ENGINEERING DEPARTMENT: Determines Compliance for Parking and Drainage. CONSERVATION COMMISSION: Determines Compliance to Wetlands Acts; i.e., If Lot(s) Border any Type of Wetlands, Streams, Ponds, Rivers, Oceans, Bogs, Bays, Marshland, Etc HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e., Requirements For Septage Disposal and other Public Health Activities. FIRE DEPARTMENT: Determines Compliance to State and Town Requirements for Personal Safety, Property Protection; i.e., Smoke Detectors, Sprinkler Systems, Etc. REVIEWED BY: ('WATER DEPARTMENT: l/ DATE: N/A: 1.2: ENGINEERING DEPARTMENT: V DATE: N/A: CONSERVATION: DATE: N/A HEALTH DEPARTMENT DATE: N/A: S. WIRING INSPECTOR: INDUSTRIAL AND/OR COMMERCIAL PERMITS N/A: 6. PLUMBING INSPECTOR DATE: N/A: 7. FIRE DEPARTMENT: DATE: COMMENTS: RECEIPT OF COPY: bitz"ZIIIJAL SIGNATURE OF APPLICANT: DATE: White copy - Buil&g Dept. - Pink copy - water Dept - Yellow Copy - HeaM Dept - Pink Copy - Engineering Dept. - Goldenrod - Fire DelA Cmvnration �•' �M1iM�'�h$IA++IWw.�i7nY.�fnvJWVaK.1ia�'}'K)WI.�.�.+WV"�+�'�M•�- •-w'.4XW Niil.war..+• ... •« ""W`MMw+wlae•.�. r`1.4M1tiIi.�'..�li+u., ^ W 3Nor Building Site Location: Proposed Improvement: . Address: TOWN OF YARMOUTH BUILDING DEPARTMENT BUILDING PERMIT APPLICATION DEPARTMENTAL SIGN OFF TRANSMITTAL SHEET s?I No: Lot No: Tel.No.:'760 J3 /� Date Filed: V // The Building Department will be responsible for assisting the applicant by dispatching your plans and or application to the following applicable departments. RESIDENTIAL AND/OR COMMERCIAL BUILDING W,�TER DEPARTMENT: ENGINEERING DEPARTMENT: CONSERVATION COMMISSION: HEALTH DEPARTMENT: FIRE DEPARTMENT: ........................................ REVIEWED BY: Determines Compliance of Water Availability and or existing location. Determines Compliance for Parking and Drainage. Determines Compliance to Wetlands Acts; i.e., If Lot(s) Border any Type of Wetlands, Streams, Ponds, Rivers, Oceans, Bogs, Bays, Marshland, Etc Determines Compliance to State and Town Regulations; i.e., Requirements For Septage Disposal and other Public Health Activities. Determines Compliance to State and Town Requirements for Personal etY} Pam' .. ; P Systems, Etc..) Safety, Pro Protection; i.e., Smoke Detectors Sprinkler S stems ................................................•------------.........-----.......---- -- - 1. WATER DEPARTMENT: DATE: N/A: 2. ENGINEERING DEPARTMENT: DATE: N/A: HEALTH DEPARTMENT: ✓lC�l�l (%(/lam/ /vG(�/ DATE:22::�N/A: f� d:3 lJ97 AND/ORINDUSTRIAL M ER A PERM FTS WIRING INSPECTOR ..f' / DATE:/ PLUMBING INSPECTOR DATE: N/A: FIRE DEPARTMENT: DATE: N/A: PLEASE NOTE COMMENTS: RECEIPT OF COPY: SIGNATURE OF APPLICANT: white copy - Bugdmg Dept. - Piok copy - Water Dept. - Yellow Copy - Health Dept - Pick Copy - g Dept. - Gold - Fire DeptiConvcvatiou Building Site Location: Proposed Improvement: Address: 03,g31 TOWN OF YARMOUTH BUILDING DEPARTMENT BUILDING PERMIT APPLICATION DEPARTMENTAL SIGN OFF TRANSMITTAL SHEET ;S F Tel.No.• '90 1312Date No: The Building Department will be responsible for assisting the applicant by dispatching your plans and or application to the following applicable departments. RESIDENTIAL AND/OR COMMERCIAL BUILDING WATER DEPARTMENT: Determines Compliance of Water Availability and or existing location. ENGINEERING DEPARTMENT: Determines Compliance for Parking and Drainage. CONSERVATION COMMISSION: Determines Compliance to Wetlands Acts; i.e., If Lot(s) Border any Type of Wetlands, Streams, Ponds, Rivers, Oceans, Bogs, Bays, Marshland, Etc HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e., Requirements For Septage Disposal and other Public Health Activities. FIRE DEPARTMENT: Determines Compliance to State and Town Requirements for Personal - _ .......----•............................................................................................................. Safety, Property Protection; i.e., Smoke Detectors, Sprinkler Systems, Etc. •---........................ REVIEWED BY: 1. WATER DEPARTMENT: DATE: N/A 2. ENGINEERING DEPARTMENT: —DATE: N/A: 3. CONSERVATION:DATE: eA �N/A: 4. HEALTH DEPART TENT: DATE: N/A. - INDUSTRIAL AND/OR COMMERCIAL PERMITS S. WIRING INSPECTOR: DATE: N/A: 6. PLUMBING INSPECTOR DATE: N/A: 7. FIRE DEPARTMENT: DATE: N/A: PLEASE NOTE COMMENTS: Ir RECEIPT OF COPY: SIGNATURE OF APPLICANT: DATE. White copy - Baild rtg DepL ' Pink ropy - Water Dept. - Ydlow Copy - health Dept. - PWk CcPy - EB=BDcpL -i GW&mdj Fire jDepuC=wyatm .1I MAP/LOT 127-24 ADDRESS_ I5S_ M �GNAu.T__AyE. PLAN INFORMATION PLAN TYPE ---A, I__R------- ----------------- ENDORSEMENT DATE ___ ! o/ Z8 _ 6�------------- RECORDING DATE ASSESSORS PLAN #-------- G_______------ PLANNING BRD. # PLAN. BRD. RELEASE 03,�3� TOWN OF YARMOUTH (,o ' BUILDING DEPARTMENT BUILDING PERMIT APPLICATION DEPARTMENTAL SIGN OFF T TRANSMITTAL SHEET Building Site Location: �•�����r CCkp L0 Map No: .7 Lot No: -;2L Proposed Improvement: Applicant: , Address: S �LU.No?760_/3e�2 Date Filed: // O The Building Department will be responsible for assisting the applicant by dispatching your plans and or application to the following applicable departments. RESIDENTIAL AND/OR COMMERCIAL BUILDING WATER DEPARTMENT. ENGINEERING DEPARTMENT: dONSERVATION COMMISSION: HEALTH DEPARTMENT: FIRE DEPARTMENT: REVIEWED BY: I. WATER Determines Compliance of Water Availability and or existing location. Determines Compliance for Parking and Drainage. Determines Compliance to Wetlands Acts; i.e., If Lot(s) Border any Type of Wetlands, Streams, Ponds, Rivers, Occans, Bogs, Bays, Marshland, Etc Determines Compliance to State and Town Regulations; i.e., Requirements For Septage Disposal and other Public Health Activities. Determines Compliance to State and Town Requirements for Personal Safety, Property Protection; i e., Smoke Detectors, Sprinkler Systems, Etc. _ ....................................................................................... cl&eA, & DATE: Q1ZA_"4 bliAr _ -- — - 3. CONSERVATION: DATE: N/A 4. HEALTH DEPARTMENT: DATE: N/A 111. vill Itteili a tr_ RAt Ir S. WIRING INSPECTOR DATE: N/A: 6. PLUMBING INSPECTOR: DATE: N/A: 7. FIRE DEPARTMENT: DATE: N/A: COMMENTS: RECEIPT OF COPY: j mm a:L�71JL� SIGNATURE OF APPLICANT: DATE: WhItC CDPY - Baild'ctg DcpL ' Pmk copy - Waxr Dcpt.. YcHow CoW -, Halth Dtpf. t Pmk� Engmca i Dcpt. = GyWcarW - Fim DepL C� TOWN OF YARMOUTH WATER DEPARTMENT 99 Buck Island Road West Yarmouth, MA 02673 Telephone: (508) 771-7921 • Fax: (508) 771-7998 Date of Issue : Apr 14, 2003 Letter of Water Availability 1. Single Family Dwelling X 2. Duplex Family Dwelling 3. Condominium Dwelling 4. Commercial / Industrial S. Other (Specify) Reference; Massachusetts General Laws Chapter 40, Section 54 To : Town of Yarmouth Building Inspector Please be advised that the Town of Yarmouth Public water supply is available to service lot/parcel(s) 24 Street 158 MERCHANT AVE as shown on Assessors sheet/map # 127 Issuance of this Letter of Availability is subject to the following provisions/restrictions. (1) The property owner agrees to comply with all Federal, State, and Local Laws, Rules and Regulations as they pertain to the use of the Public water Supply. (2) The Yarmouth Water Department shall have exclusive rights as _ to the size, number, type and location'of all water service lines, fire service lines or appurtenant items connected to the water distribution system. (3) The Yarmouth Water Department reserves the right to require, at the property owners expense, the installation of water mains and appurtenant items to meet water demand requisites within any structure relevant to this Letter of Availability. (4) This Letter of Availability will expire 180 days from the date of issue. I have read and understand the provisions/restrictions of this Letter of Water Availability. Owner (Sign) Reference : ROBERT DUNPHY : 218 BLUE ROCK RD : SOUTH YARMOUTH, MA 026 4 Yarmout Water Department `•..r. ... .. '�. r... w�,: r;. .'.. I:. �..,..-.�: rf..:.: tJ •1•�Yi�. •.lif...%„ .v.",��.�r_ ...+,J..a-..r..s•. r a '.0 .... r.w ���a ..'a.l"1'f�n.-, .. U3-L�3y TOWN OF YARMOUTH 1 BUILDING DEPARTMENT ZG�13 IYP.rmn`,h i,', pelt. BUILDING PERMIT APPLICATION DEPARTMENTAIfSIGN-OFF_._. TRANSMITTAL SHEET Building Site Location: / S Proposed Improvement: Address: 4/l No: /21 Lot No: a� :176l /3 /�/ Date Filed: ' / / The Building Department will be responsible for assisting the applicant by dispatching your plans and or application to the following applicable departments. RESIDENTIAL AND/OR COMMERCIAL BUILDING WATER DEPARTMENT: Determines Compliance of Water Availability and or existing location. ENGINEERING DEPARTMENT: Determines Compliance for Parking and Drainage. CONSERVATION COMMISSION: Determines Compliance to Wetlands Acts; i.e., If Lot(s) Border any Type of Wetlands, Streams, Ponds, Rivers, Oceans, Bogs, Bays, Marshland, Etc HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e., Requirements For Septage Disposal and other Public Health Activities. FIRE DEPARTMENT: Determines Compliance to State and Town Requirements for Personal Safety, Property Protection; i.e., Smoke Detectors, Sprinkler Systems, Eta REVIEWED BY: 1. WATER DEPARTMENT: DATE: /s 0-3 N/A: 2. ENGINEERING DEPARTMENT: DATE: N/A: 3. CONSERVATION: DATE: N/A 4. HEALTH DEPARTMENT`. DATE: N/A: 3. WIRING INSPECTOR: DATE: N/A: 6. PLUMBING INSPECTOR: DATE: N/A: 7. FIRE DEPARTMENT. DATE: CKl1i� � 11 �� RECENT OF COPY: SIGNATURE OF APPLICANT: DATE: White ropy - Buddmg DePL - Pwk ropy - W&W Dept - Ydlow Copy - Hah6 DcpL - Pick COPY -Egxxdg Dc - Goldenrod - Fiie Dcpt Con=vabw n�a� eftrd MULTI -POSITION CONDENSING llfTt GAS FURNACE GMPN SERIES U.S. Patent No. 5,437,263 YI1110• G8'iila DESCRIPTION / APPLICATION . All models design certified by ETL and ETL c Testing Laboratories in compliance with Unified - . .... Standard . Completely assembled, factory tested furnace for heating or combination heating/cooling application. . For utility room, closet, alcove or basement application. . Vertical or horizontal venting with 2" diameter PVC for 40k, 60K 80k and 3" diameter for 100k, 120k. . Capable of multiple position Installation - upflow, downflow, or horizontal. CONSTRUCTION . Heavy gauge, reinforced, wrap -around insulated, steel cabinet with durable baked enamel finish. . Aluminized steel heat exchanger cells featuring the "weld free" manufacturing process. . Left, right side or bottom inlet air return. . Aluminized steel In -shot burners. . Convenient right & left hand connection for gas and electric service. . Removable solid bottom blockoff. OPTIONAL EQUIPMENT . L P. conversion kit (L.P. kit model LPM-01) . Combustible floor base for downflow application. TNf wxa N% as «s m STANDARD EQUIPMENT . Electronic hot surface ignition system with - - diagnostics. . Corrosion resistant stainless steel secondary heat exchanger which extracts the maximum amount of energy from the gas and converts it to usable heat. . Energy saving PSC multispeed direct drive blower motors. . Blower door safety switch. . Outlet air temperature limit control. . Pressure switch for proof of combustion air. . Combination redundant gas valve and regulator. . Corrosion resistant induced draft motor/blower assembly. . 40va transformer for heating and cooling operation. . Temperature limit control at vent blower outlet, guards against excessive exhaust gas temperatures. . Multiple flame roll -out switches. . Drain kit includes vent screens, drain trap assembly, hoses & clamps. As an Energy Star Partner, Goodman Manufacturing Company, L.P., has determined that this product meets the Energy Star guidelines for energy efficiency SS-209D Goodman Manufacturing Company, L.P. GMPN Series 1/97 1501 Seamist - Houston, Texas 77008 0.95 w 0.95 of N 0.75 H 0.65 d 0.55 0.45 U 0.35 0.25 t~/O 0.15 coo AIRFLOW DATA TEMPERATURE RISE (F) - NATURAL GAS ., m � N Y t In'! m N N N N O O O O O O O O O O O tv ♦ In .o n m 0% CFM - NO FILTERS TEMPERATURE RISE (F) - NATURAL GAS o n o n o n o n . _ 7 0.75 ` to 0.65 -' am _ d 043 F 035 GMPN090.4 N 0.2s ii2 HIP MTR 0.15 10 X B BLWR -\ 000 m P J J J J J J J J J J CFM - NO FILTERS TEMPERATURE RISE (F) - NATURAL GAS n n .no .00 n n v N%.l Q05 0.75 0.65 0.45 0.35 GMPN120.5 �- Ws 314 HP MTR. -� 0.15 (2) 10 X 6 BLWR. ao0 a J J J J J J J o J ri 11I .1I N r fl CFM - NO FILTERS TEMPERATURE RISE (F) - NATURAL GAGS 0.95 0.95 Q 0.75 N 0.63 0.55 Cc a 0.45 F 0.35 N 0.25 0.15 000 mmm ammmmm mmm m �a. mmmm m_mmmmmm . . a g o 0 0 CFM - NO FILTERS TEMPERATURE RISE (F) - NATURAL GAS a n a n e n e n a n a n P m m n n b b n n m 0.95 0,83 0.75 N 0.63 W 0.55 O. 0.45 F 0.35 0.25 h 0.15 0.00 ----_- loxioBLVM MoMmm CFM - NO FILTERS LOW - - MED HGH • • Performance Data Model No. GMPN Input* Nat. & L.P. BTUH Output BTUH DOE** AFUE Temp. Rise. Range 040-3 40,000 36,000 92.6 25-55 060-3 60,000 54,000 92.6 35-65 080-4 80,000 72,000 92.6 35-65 100-4 100,000 90,000 92.6 40-70 120-5 120,000 108,000 92.6 35-65 • For altitudes above 2,000 ft. reduce ratings 4% for each 1,000 tt above sea level "DOE AFUE based upon Isolated Combustion System (ICS) BEFORE PURCHASING THIS APPLIANCE, READ IMPORTANT ENERGY COST AND EFFICIENCY INFORMATION AVAILABLE FROM YOUR RETAILER Specification Data Model No. GMPN Blower Vent* Dia. In. Fitter"* Size In. Electrical Ship Wt. Motor H.P. Speeds Dia Width FLA Max. Fuse 040-3 1/3 4 10 6 2 1991n2 4001n2 5.2 15 170 060-3 1/3 4 10 6 2 240 In2 / 480 In= 5.2 15 180 080-4 1/2 3 10 8 2 3201n2 6401n2 7.8 15 205 100-4 1/2 3 10 10 3 3631W / 7271n2 7.8 15 225 120-5 3/4 3 10 1 6(2) 3 480 In2 / 960 In2 9.6 1 15 265 • Schedule 40 PVC pipe, DWV •' After dimensions for bottom application. Ali models require 18" x 254 fdter(s) for side a'u Installations. Permanent air filters recom ended. Where max. au flow is 1800 CFM or greater, both sides or the bottom must -be used for return au. I / c Dimensions (Inches) l2t 7* a '22?j_ I '�*� Model Identification P Model No.h241/21 B C 040-312 1 2 12 1 2 060-312 1/2 12 1/2 080-4 16 16 100-4191 2 19112 120-5 23 1 23 COMBUSTIBLE FLOOR BASE FOR DOWNFLOW APPLICATION GMPN040-3 SBM14 GMPN060-3 SBM14 GMPN080-4 SBM17 GMPN100-4 SBM21 GMPN120-5 SBM24 P_IAaronr•Ac fmm r11mhttaflhlA Untarlala fall mndalal Top Sides I Rear I Topront*Vent Hortz jUptlow 1' 1 0' 1 1' 1 3' 1 0' 8' 1 1' • Accessibility clearance shell We precedence where greater G M P N 060 3 Gas Furnace Mufti Position Condensing Input(MBTU) Tons Cooling (Nom) (Nom) CASEDMCOILAPPLICATIONOPTIONS FURNACE MODEL NO. GMP050-3 GMP075-3 GMPN040-3 GMPN060-3 *GSU060-3 GMP075-4 GMP100-3 GMP100-4 GMPV075-1.5/3 GMPNO80-4 *GSU080-4 GMP100-5 GMP125-4 GMP125-5 GMPV100-3/5 GMPV125-3/5 GMPN100-4 *GSU100-4 GMP150-5 GMPN120-5 NOMINAL FURNACE WIDTH 14" 171/2' 21' 241/2" DFK MODEL NO. 3 DFK-14 DFK-17 DFK-21 DFK-24 COIL MODEL NO. NOMINAL COIL WIDTH U-18 14" X U-29 14" X U-30 171 /2" X(1) X(2) U-31 14" X U-32 171 /2' X(1) X(2) U-35 14' X U-36 17 1/2' X(1) X(2) U-42 17 1/2' X(1) X(2 U-47 17 1 /2" X U-49 21' X(1) X(2) U-59 21" X(1) X(2) U-60 241/2" X(1) X(2) U-61 241/2' X(1) X(2) U-62 21" X(1) X(2) (1) - Utilizing factory Installed bottom cabinet filler plates. (2) - Discard bottom cabinet filler plates. (3) - Downflow Coll Adapter KA allows use of U coils in downflow applications. * - Upflow Application only UC COIL INSTALLATION RECOMMENDATIONS: MINIMUM DISTANCE BETWEEN GAS FURNACE FURNACE AND COIL PAN: 2' DFK(3) fYtD FABRICATED SUPPORT FOR UNCASW COIL COIL CAS FURNACE �J Note: A Do not use this cog on oil furnaces or any applications where the temperature on drain pan may exceed 300*F. Use the following metal drain pan3:15236.1a (U-16 thru U32),15236-19 (U36 thru U-47).15236-20 (UIUC•60 thru U-61), and 15236-12 (UA)C-9, U-59, and U-62) for those applications. B. Due to the rating mWmatch of various coils with outdoor units it is Important to match the fumace air flow for the total system capacity. (Refer to furnace spec. sheet & condenser/heat pump spec. sheet) MAScheck COMPLIANCE REPORT Massachusetts Energy Code MAScheck Software Version 2.01 Release 3 TITLE: CITY: Yarmouth STATE: Massachusetts HDD: 6137 CONSTRUCTION TYPE:1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non -Electric Resistance) DATE:4/20/03 DATE OF PLANS: New PROJECT INFORMATION: 158 Merchant Ave. COMPANY INFORMATION: LIVING DESIGNS 131 QUAKER MEETINGHOUSE ROAD EAST SANDWICH, MA. 02537 1-508-888-2747 COMPLIANCE: Passes Maximum UA a 404 _ Your Home a 400 CEILINGS WALLS: Wood Frame, 16" O.C. WALLS: Wood Frame, 16" O.C. GLAZING: Windows or Doors GLAZING: Windows or Doors DOORS FLOORS: Over Unconditioned Space HVAC EQUIPMENT: Boiler, 83.0 AFUE I Permit # I I I Checked by Date I Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Value U-Value . UA -------------------------------------------- 1344 30.0 0.0 47 1117 11.0 0.0 99 867 11.0 0.0 77 151 0.350 53 125 0.350 44 52 0.330 17 1344 19.0 0.0 63 ------------------------------------------------------------------------------- COMPLIANCE STATEMENT: The proposed building design described here 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 th esig oad as specified in Sections 780CMR 1310 4 4.4. TITLE: Custom Cape MAScheck INSPECTION CHECKLIST Massachusetts Energy Code MAScheck Software Version 2.01 Release 3 DATE: 4/20/03 , Bldg.I Dept. I. Use I I CEILINGS: (1 I 1. R-30 i Comments/Location I 1 WALLS: ( ] I 1. Wood Frame, 16" O.C., R-13 I Comments/Location I I WINDOWS AND GLASS DOORS: [ 1 I 1. U-value: 0.41 I For windows without labeled U-values, describe features: I # Panes Frame Type Thermal Break? [ J Yes [ ) No Loc I Comments ation I I DOORS: [ ] I 1. U-value: 0.33 I Comments/Location I ( FLOORS: ( 1 1 1. Over Unconditioned Space, R-19 Comments/Location I HVAC EQUIPMENT: 1. Boiler, 82.5 AFUE or higher 1 Make and Model Number I I AIR LEAKAGE: [ J I Joints, penetrations, and all other such openings in the building I envelope that are sources of air leakage must be sealed. When I installed in the building envelope, recessed lighting fixtures I shall meet one of the following requirements: I 1. Type IC rated, manufactured with no penetrations between the I inside of the recessed fixture and ceiling cavity and sealed or I gasketed to prevent air leakage into the unconditioned space. I 2. Type IC rated, in accordance with Standard ASTM E 203, with no I more than 2.0 cfm (0.999 L/s) air movement from the the I conditioned space to the ceiling cavity. The lighting fixture I shall have been tested at 75 PA or•1.57 lbs/ft2 pressure I difference and shall be labeled. I I VAPOR RETARDER: I 1 I Required on the warm -in -winter side of all non -vented framed I ceilings, walls, and floors. I MATERIALS IDENTIFICATION: [ 1 I Materials and equipment must be identified so that compliance can I be determined.. Manufacturer manuals for -all installed heating I and cooling equipment and service water heating equipment must be I DUCT INSULATION: [ l I Ducts shall be insulated per Table J4.4.7.1. I I DUCT CONSTRUCTION: [ ] ( All accessible joints, seams, and connections of supply and return ( ductwork located outside conditioned space, including stud bays or ( joist cavities/spaces used to transport air, shall be sealed ( using mastic and fibrous backing tape installed according to the ( manufacturer's installation instructions. Mesh tape may be omitted where gaps are less than 1/8 inch. Duct tape is not I permitted. The HVAC system must provide a means for balancing air and water systems. I ( TEMPERATURE CONTROLS: [ ] ( Thermostats are required for each separate HVAC system. A manual I or automatic means to partially restrict or shut off the heating and/or cooling input to each zone or floor shall be provided. I ( HVAC EQUIPMENT SIZING: ( ] I Rated output capacity of the heating/cooling system is I not greater than 125% of the design load as specified ( in Sections 780CMR 1310 and J4.4. I SWIMMING POOLS: ( ] I All heated swimming pools must have an on/off heater switch and I require a cover unless over 20% of the heating energy is from I non-depletable sources. Pool pumps require a time clock. I HVAC PIPING INSULATION: [ ] I HVAC piping conveying fluids above 120 F or chilled fluids below 55 F must be insulated to the following levels (in.): i .... _..•. _ PIPE SIZES (in.). HEATING SYSTEMS: TEMP (F) 2" RUNOUTS 0-1" 1.25-2" 2.5-411 I Low pressure/temp. 201-250 1.0 1.5 1.5 2.0 I Low temperature 120-200 0.5 1.0 1.0 1.5 I Steam condensate any 1.0 1.0 1.5 2.0 I COOLING SYSTEMS: I Chilled water or 40-55 0.5 0.5 0.75 1.0 ( refrigerant below 40 1.0 1.0 1.5 1.5 I I CIRCULATING HOT WATER SYSTEMS: I I I Insulate circulating hot water pipes to the following levels (in.): I ' I PIPE SIZES (in.) I NON -CIRCULATING I CIRCULATING MAINS 5 RUNOUTS ( HEATED WATER TEMP (F): RUNOUTS 0-1" ( 0-1.25" 1.5-2.0•' 2.0+" I 170-180 0.5 I 1.0 1.5 2.0 ( 140-160 0.5 ( 0.5 1.0 1.5 I 100-130 0.5 (� 0.5 0.5 1.0 ----NOTES TO FIELD (Building Department Use Only)-- w Level Name: Application: Member Calculations Report DMid -Cape Home Centers Route 134 D Z�o3 PO Boa1418 So Dennis, NIA 02660 508-398-6071 e:t4987 508-3984559 nv Floor FLOOR 24' 3 1/2" Status: Ready to Plot Nan -Residential: No Design Date: 6/10/0311:04:34 ANl Report Date: 6/10/03 11:17:44 ANI Obiect: Drop Beam H23 General: Product: 7" x 18" 2.0E Parallam PSL Plies: 1 Deflection Criteria: Standard, Live Load U360, Total Load L/240 Member Weight (plf) per ply: 39.4 - Moment (Ft-Ibs) - Shear (Ibs.) Live Load Deflection (") Total Load Deflection (") Reaction (lbs.) Bearines• IV Design Value Control Value Result 63113 . _ _ ... _ . 87330 . .. . _ ._ - -Passed _ -10130 24360 Passed .75" .8" Passed 1.03" 1.2" Passed 11482 18375 Passed Bearing Location Input Length Required Length I Wall # 1 24' 3 1/2" 3 1/2" 3 1/2" 2 Wall # 7 0 3 1/2" 3 1/2" Reactions: Assumed Member Weight (plf): 14 Location Dead Load Live Load Total Load Uplift (Ibs.) 24' 1 1/2" 3031 8143 11173 0 2 (Ibs.) 2" 2810 7990 10800 0 Loads: Load Location Live Dead Type Distributed (plf) 0 to 3 1/2" 681.9 to 681.9 197.3 to 197.3 Floor Distributed (plf) 0 to 3 1/2" -24.4 to -24.4 0 to 0 Floor Distributed (plf) 3' 101/4" to 3 1/2" 578.2 to 578.2 137.1 to 137.1 Floor Distributed (plf) 3' 101/4" to 3 1/2" -121.3 to -121.3 0 to 0 Floor Distributed (plf) 3' 101/4" to 4' 13/4" 581.8 to 581.8 138.3 to 138.3 Floor Distributed (plo 3110 1/4" to 4' 13/4" -120.8 to -120.8 0 to 0 Floor Distributed (plf) 4' 13/4" to 12' 13/4" 581.8 to 581.8 138.3 to 138.3 Floor Distributed (plf) 4' 13/4" to 12, 13/4" -120.8 to -120.8 0 to 0 Floor Distributed (plf) 12' 1 3/4" to 19' S 1/2" 581.8 to 581.8 138.3 to 138.3 Floor TJ-Xpert630 (#686) A Page 1 DUBLIN 159 MERCIIANTJOB DeyE.tDate: 6/10/03 11:04:34 A111 Report Date: 6/10/0311:17:44 AM Distributed (plf) 12' 1 3/4" to 19' 5 1/2" -120.8 to -120.8 0 to 0 Floor Distributed (plf) 19' S 1/2" to 20' 13/4" 581.8 to 581.8 183.4 to 183.4 Floor Distributed (pl)) 19' 5 12" to 20' 13/4" -120.8 to -120.8 0 to 0 Floor Distributed (plf) 20' 13/4" to 20' S 1/4" 581.8 to 581.8 183.4 to 183.4 Floor Distributed (pll) 20' 13/4" to 20' S 1/4" -120.8 to -120.8 0 to 0 Floor Distributed (pll) 20' S 1/4" to 2119 3/4" 578.2 to 578.2 181.7 to 181.7 Floor Distributed (plf) 2015 1/4" to 2119 3/4" -121.3 to -121.3 0 to 0 Floor Distributed (plt) 24' 3 12" to 21' 9 3/4" 578.2 to 578.2 137.1 to 137.1 Floor Distributed (plf) 2413 12" to 21' 9 3/4" -121.3 to -121.3 0 to 0 Floor Concentrated (lbs.) 4' 10" 804 905 Floor Concentrated (lbs.) 19' S 12" 804 813 Floor Concentrated (lbs.) 21' 9 3/4" 316 293 Floor Notes: Design Methodology: ASD Only positive (downward acting) loads are detailed in the diagram above. IMPORTANTI The analysis presented above is output from software developed by Trus Joist (TJ). Allowable product values shown are in accordance with current TJ materials and code accepted design values. The specific product application, input design loads and stated dimensions have been provided by others, have not been checked for conformance with the design drawings of the building, and have not been reviewed by TJ Engineering. TJ-Xpert6.30 (#686) A Page 2 DUBLIN 158 MERCHAN1'.10B Member Calculations Report • Level Name: Application: Mid -Cape Home Centers Route 134 PO Box1418 So Dennis . NW 02660 508-398-6071 ext4987 508-398-4559 23' 0 1/2" Status: Yon -Residential: No Design Date: 6/16/2003 11:49:40 AM Obiect: Drop Beam #17 Report Date: 6/17/2003 11:54:16 ANl General: Product: 3 1/2" x 18" 2.0E Parallam PSL Plies: 1 Deflection Criteria: Standard, Live Load L/240, Total Load L/I80 Member Weight (plf) per ply: 19.7 Design Value Control Value Moment (Ft-Ibs) 45630 _.. 50215 Result Shear (Ibs.) _ .-- -6653 00 14007 Passed' Live Load Deflection (") .92" 1 Passed Total Load Deflection (") 1.44" 1.18" Passed Reaction (Ibs.) 7726 7726 Passed Bearings: Passed Bearing Location Input Length 1 Column By Others # 43 23' 8 1/2" 1 3/4" Required Length 2 Column By Others # 20 0 1 3/4" 2 15/16" Reactions: 2 15/16" Assumed Member Weight (plf): 14 Location Dead Load Live Load Total Load Uplift 1 (Ibs.) 23' 8 1/4" 2731 4927 7658 0 2 (Ibs.) 1/4" 2731 4927 7658 0 Loads: Roof Load Duration Factor: 115% Load Location Live Dead Distributed (plf) 0 to 23' 8 1/2" 207.8 to 207.8 108.2 to 108.2 Distributed (plf) 0 to 23' 81/2" 207.8 to 207.8 108.2 to 108.2 Notes: Design Methodology: ASD IMPORTANTI The analysis presented above is output from software developed by Trus Joist (TJ). Allowable product values shown are in accordance with current TJ materials and code accepted design values. The specific product applica loads and stated dimensions have been provided by others, have not been checked for conformance with e� building, and have not been reviewed by TJ Engineering. the desig� TJ-Xpen 630 (#686) A Page 1 DUBLIN 158 Type Roof Roof Member Calculations Report , Mid -Cape Home Centers Route 134 PO Box1418 So Dennis, NIA 02660 508-398-6071 ext4987 508-398-1559 Level Name: ROOF LOADS Status: Ready to Plot Application: Roof Nan -Residential: No - F1 16' 3 1 2 Design Date: 6/16R003 11a9:40 AM Report Date: 6/17/2003 11:54:00 AM Obiect: Flush Beam #15 General: _ Product: 13/4" x 14" 1.9E Microllam LVL Plies: 2 v Deflection Criteria: Standard, Live Load L/240, Total Load U180 Member Weight (plf) per ply: 7.1 Moment (Ft-Ibs) Shear (Ibs.) Live Load Deflection (") Total Load Deflection (") _ _ Reaction (Ibs.) Bearines: Design Value Control Value Result 17254 27897 Passed 3652 10706 ;. Passed .35" .79" Passed .55" 1.05" Passed 4376 __........_ _._ . -_ .. - 4594 ... _ .. _ _.. - _- Passed '- - Bearing 1 Wall # 13 2 Wall # 14 3 Column By Others # 42 Reactions: Assumed Member Weight (plf): 14 Location 1 (Ibs.) 13/4" 2 (Ibs.) 13/4" 3 (Ibs.) 15' 11 3/4" Loads' Roof Load Duration Factor: 115% Load Location Distributed (plf) 0 to 16' Distributed (plf) 0 to 16' Notes: Design Methodology: ASD Location Input Length Required Length 0 3 1/2" _ 3 1/2" 0 3 1/2" 3 1/2" 16' 13/4" 13/4" Dead Load Live Load Total Load Uplift 800 1428 2228 0 800 1428 2228 0 1571 2804 4375 0 Live Dead Type 176.9 to 176.9 92.1 to 92.1 Roof 176.9 to 176.9 92.1 to 92.1 Roof TJ-Xpert6.30 (#686) A Page 1 DUBLIN 158 btERCIiANTJOB Design Date•. 6/16/200311:49:40 AAl Report Date: 6/17/200311:54:00 AJI IMPORTANTI The analysis presented above is output from software developed by Trus Joist (TJ). Allowable product values r shown are in accordance with current TJ materials and code accepted design values. The specific product application, input design loags and stated dimensions have been provided by others, have not been checked for conformance with the design drawings of the • ' b6ilding, and have not been reviewed by TJ Engineering. TJ-Xpert 630 (M686) A Page 2 DIJBUN 158 MERCHANT.JOB M APPLICATION FOR PERMIT TO DO PLUMBING *"W a ' (OFFICE USE(ONLY) By /►-e- JUN 0 7 2004 Fee: $ 'ez) 4 IS-tG /a o- PERMIT NO. P-0 %9: 7 �— -- Date (o Building S��v` a Owner's AT. Location Name NeAal Plans Submitted Renovation ❑ Yes[] No[] Type of Occupancy Replacement ❑ z Z N J N Q 0 V Y N cc Y V7 Q M (7 rA per, V N Q m N x x ~ Q W uJ Y¢ a U. a Q Z tr N W Q I- Cn Z O Q N Z¢ O a X 0 W x Q = 3 0 Z x 3 Y 0 0 F- Q Y a W U. U. W Q O Q-1_j W F a O t. x Y J m N 0 0' 5 3 x r N U. Q¢¢¢ a M 0 0 cc a m F- o SUB-BSMT. BASEMENT 1ST FLOOR TT— 2ND FLOOR 3RD FLOOR (PRINT OR TYPE) Installing Company Name Address L- u3 Z Check One: orp. _ ❑ Partnership ❑ Firm/Company Business Telephone 28-1 � 373'1�' Name of Licensed Plumber. INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent. Check One: Yes Er— o ❑ If you have checked YES, please indicate the type of coverage by checking the appropriate box. A liability insurance policy ❑ Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance voerage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Signature or Owner or Owner's Agent I hereby certify that all of the details and Information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and Installations performed under Permit issued for this application will be In compliance with all pertinent provisions of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. Check on Owner ❑ Agent ❑ Signature of Licensed Plumber License Number Type: Master 0� Journeyman ❑ (,O�r ? OF Pill TOWN; •YARMOUTH = I � I 7 EP �2 2004 IC Fly APPLICATION FOR PERMIT TO DO GASFITTING (OFFICE USE ONLY) By Fee: $ 7 �� PERMIT NO. Building Owner's Owner's �7 AT: Location �F/ /�GVi'if%t �- Name b0` Newg� Pas Obmitted Type of Occupancy Renovation ❑ Replacement ❑ Yes ❑ No ®-� ' YQ NCC W QO WW N w O V }° C2 Z =rn N W ° � W W o'�~a W W Q W W Z Q Q= Z > W cc O W W f- W J ca W I380l Z -� �=LLD FW- 3 00 rA 3 Z O >0IL W aac=>0 U arc 0 SUB- SMT. BASEMENT 1ST FLOOR 2ND FLOOR � 3RD FLOOR (PRINTORTYPE) Installing Company Name Address Check One: ❑ Partnership U/I'lU00% C,zfbG ❑ Firm/Company Business Telephone1/ %- 2-3 6 Name of Licensed Plumber or Gasfitter X4 t, G INSURANCE COVERAGE: Check O I have a current liability insurance policy or its substantial equivalent. Yes No ❑ If you have checked yes, please indicate the type of coverage by checking the appropriate box. A liability insurance policy ❑ Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check One: Owner ❑ Agent ❑ Signature of Owner or Owner's Agent -r I hereby certify that all of the details and Information I have submitted Signature of Licensed (or entered) in above application are true and accurate to the best of Plumber or Gasfitter my knowledge and that all plumbing work and Installations performed `Gcja—/ under Permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Plumbing Code and License Number Chapter 142 of the General Laws. TYPE LICENSE: lumber ❑ Gasfitter L aster ❑ Journeyman .I - EX577NG FOUNDA77ON J NOV ?� 2003 6 S� Imo• ' _ . _. LOT 46 AREA 1$682f SF. (to rNa. V6l TOP OF FOUNDATION ELEVATION IS >2' ABOVE HIGH POINT OF ROAD. (SITE PLAN DATUM). TO THE BEST OF MY INFORMATION, KNOWLEDGE, AND BELIEF THE FOUNDATION SHOWN ON THIS PLAN HAS BEEN LOCATED ON THE GROUND AS INDICATE 1117103 102903 DATE PROFESSIONAL LAND StfRVEYC "AS -BUILT" PLOT PLAN YARMOUTH, MASS LOT 46, PL. BK. 225 PG. 103 DATE 10/29/03 SCALE 1" = 30' JOB 5596-00 CLIENT DUBLIN SWEETSER ENGINEERING 235 GREAT WESTERN ROAD PO BOX 713 SOUTH DENNIS, MA 02660 ff. 508-398-3922 fax. 508-398-3063 a S8�PROJ�5596-00�dwg�5596-CPP46.DWC 5(1312015 SlipGen- Portal Hone Document Category Map -Block Number Street Number Street Name Town of Yarmouth Template [Building Dept] Slipsheet Identifier [sg25466] Building Permits 127.24 0158 MERCHANT AVE Department Building Parcel ID 16041 ___Backfile Batch Scan ---- Document? Additional Naming Info Index Operator Date - Time No Operator, Yarmsean 2015-05-13 - 14:36 httpJllaserfiche121SlipGerV 1/1