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1600 TO THE APPLICANT/REFERRAL AND APPROVAL
%
Date of Application submission / Z 7
Plat / A Lot Ze�— Street_
Owner
Owner mail address
Zone
Owner phone #
OTHER INVOLVED AGENCIES - The following agencies require separate jurisdictional permits or approval for your
proposed project. CONTACT THEM FOR REQIRlQyp SOBMISSIONIS.
® TAX COLLECTOR Approved C HOLD By
❑ Board of Appeals ❑ Approved By
❑ Conservation Commission ❑ Approved By
❑ D.P.W. Water :1 Approved By ❑ D. '.W.
❑ D.P.W. Cross Connection u Approved By _1
Date
Date
Approved By Date
Date
❑
Treasurer (Bond) ❑ Approved By
Date
❑
D.P.W. Engineering. [I Approved By
Date
7
Board of Health (well) Approv By
Date
❑
Board of H th (septic) C proved By
Date
❑
Board of Heal ood service) r- Approved By
Date
❑
Planning Board (parking) = Approved By
Date
®
FIRE DISTRICT (I - II . IIi) :; Approved By
sss:::s:sssssssssssssss:ssssssssssssssssss:sssssssssssss:sssssssssss:sss:sssssssssssssssssssssssssssssss
Date
BUII.ISING
DEPARTMENT APPROVAL:
❑ ZONING
❑ BUILDING INSPECTORBUILDING COMMISSIONER
❑ CONTROL CONSTRUCTION AFFIDAVIT
PROBECT SUMMARY:
new construction/ alteration/demo sewage disposal - public/private
[Alter/add interior walls] [add rooms] [add footprint] water supply - public/private well
[pool] [garage/she eck [game court] [food servic ]
Describe
To the various departments:
This notice has been forwarded to you for your information and any appropriate action. Should you have any
questions please advise. If any reason to withhold the requ7i�//
mit is found, please advise. Your assistance
cooperation is appreciated.
The Building Department - Date sent for review
B
TOWN OF DARTMOUTIH. BUILDIl�G DEPARTMENT.
TELEPHONE .508-999-0720 FAX508-99-0738
APPLICATION FOR ZONING AND BUILDING PERMIT
InstracSom
The applicant shall complete this application to the best of their ability prior to submission, leaving no item unanswered. The
Department staff will be available during regular business homy to assist as necessary. N/A should be inserted for those sections
which do not apply. A properly completed application will help avoid unnecessarydelays. Main FW=g fees sst r
(for office use only)
Total Cost Z Received By
Less Application Fee
Total Permit Fee S Permit #
100 LOCATION OF PROJECT
O HI.Y
Date Rec'd � //
Lwued Date
TOTAL LAND AREA SQUARE FEET 4 %li
CURRENT ACCESSORS' PLAT LOT ZONING DISTRICT
OTHER ZONING OVERLAY DISTRICTS.., if applicable
NUMBER & STREET 1� SAFFNCI Rb
NEAREST CROSS STREET Rocr,- 6- 0 U M D E C
SUBDIVISION NAME & LOT #
or BUSINESS NAME
PREVIOUS TENANT / OWNER f
200 RESIDENTIAL - PROPOSED PROJECT - one & two family residence only
THIS SECTION NOT APPLICABLE
Single family - number bedrooms number baths
Two family - number bedrooms unit 1 _ number paths unit i _
number bedrooms unit 2 number baths unit 2
Accessory apartment Total gross sq. ft.
Accessory structure:
Garage - detached - attached to dwelling, dimensions L W
Carport - detached - attached to dwelling, dimensions L W
Shed - dimensions L W
'ter, Deck - dimensions L W
L Gazebo - dimensions L W
Swimming pool above ground in -ground Size
LE Chimney - number of flues
Q
Woodstove - used (will require inspection prior to installation), new (provide manufacturers
The following section for official use oniv
instructions). Location(s) (list)
C Fireplace(s) - (includes flue) List locations)
C Game Court —describe (include overall
u Tent, Trailer (Mobile Home)
d /C ill n � a,h tm XI"e"f fQ,
300 COMMERCIAL - PROPOSED PROJECT/USE - INCLUDING THREE FAMILY OR MORE AND EXEMPT
C THIS SECTION NOT APPLICABLE
(The following descriptions are based on the Massachusetts State Building Code Article 3, AS NOTED) (See the
Code)
'� Assembly - restaurant, lounge, theater, school, etc. (see Code Section 302.0) Describe
Business - office, assembly with less than 50 occupants - indicate Medical or other professional (see Code
Section 303.0)
Educational - structure for training including child day care for those over 2 years 9 months (see Code Section
304.0)
C Factory / Industrial - (see Code Section 305.0)
High Hazard - (see Code Section 306.0)
E Institutional - hospital, nursing home, infant day care (see Code Section 307.0)
Mercantile retail stores (see Code 308.0)
Residential - three or more family, hotel (see Code Section 309.0)
j Storage - includes garages (see Code Section 309.0)
C Utility & Miscellaneous Structures - includes tents and ..:gr►cnitural structures (see Code Section 311.0)
C New tenant for any of the above, indicate above (see Code Section 119.0 and Zoning By-law section 35)
E: Tent or Trailer - temporary purpose?
r' Other
Describe the pr—,pm. ^oi Isil;y, P,%CLUDE rumber of dwelling units and bedrooms or occupant load as applicable,
also eustmg condition
400 TYPE OF CONSTRUCTION OR WORK TO BE PERFORMED
New Construction and/or Addition - total gross square feet
(For commercial only total gross cubic feet) indicate
It will be considered new construction if there an increase in square footage in addition to any
alteration(s).
If project is an addition to existing structure - Total gross square feet of existing
u FOR COMMERCIAL ONLY
Will this project be subject to CONSTRUCTION CONTROL (over 35,000 cu.ft.) Yes No. (If yes
see Code section 127.0). Designer to submit Code Synopsis.
Will this project require Peer review (over 400,000 cu.ft.) Yes No (see Code Appendix 1)
APPLICANT TO PROVIDE
ter, "� C_r..y,
INSPECTORS' REVIEW
Date plan reviewed /
30 days to review period expires
OK to issue date
J OK to issue subject to requested submittals (see project review worksheet) date
DENIED see project review worksbeet date
HOLD reason date
77 HOLD Subject to Zoning Board of Appeals action
Comments
Inspectors signature
Date'EC 2 4 M7
Applicant informed of above - Date time staff
(fax, phone, in person)
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Over six months since approved for issue - DEEMED abandoned!
Advise applicant. Hold 90 days for return then dispose if not picked up.
Inspector Date
Advised applicant Date Time staff (by phone, fax or in person)
OFFICEIINSPECTORS NOTES
TOTAL FEE
Gross area - new construction Total Sq. Ft.
alteration Total Sq. Ft.
Permit is issued to
Comments/notes on permit
2
tsvo t:wrIKK SIGN - OFF
_ Alteration of existing, no increase in gross square feet. A separate Refuse Disposal Declaration required.
I, the undersigned, am the owner, of record or authorized lessee (provide documentation) and I have reviewed
the application herein submitted. I state that to the best of my knowledge and belief that the information provided in this
application is true -and correct and that the permit requested be issued.
Further I understand that the permit will expire in six months, from the date of issue, if no work is begun or
six months after the last inspection if work has begun and that the permit may be extended for six months if no work is
anticipated if I request such an extension in writing. I understand that the permit may be extended only three times by
written request. I understand that once the permit expires a new application may be required, including fees and current
other requirements including Zoning).
Name
Signature
abovdsignature is my voluntary act awf�s signed under the pains and penalties of e
� perjury.
ry.
Date �% 2-
Who is authorized to pickup the permit at the Building Department?
Address Phone
1400 HOMEOWNER EXEMPTION - ONE & TWO FAMILY ONLY
t�
FOR HOME OWNERS WHO INTEND TO PERFORM AND BE RESPONSIBLE FOR THEIR OWN PROJECT
109.1.1 Licensing of Construction Supervisors: Except for those structures governed by Construction Control
in Section 127.0, effective July 1, 1982, no individual shall be engaged in directly supervising persons engaged in
construction, reconstruction, alteration, repair, removal or demolition involving the structural elements of buildings or
structures, unless he or she is licensed in accordance with t'he rules and regulations promulgated by the BBRS entitled
Rules and Regulations for Licensing Construction Supervisors.
Exception: Anv Home Owner performing work for which a Building Permit is required shall be exempt from
the provisions of this section; provides that if a Home Owner engages a person(s) for hire to do such work ,that such
Home Owner shall act as supervisor.
For the purposes of this section only, a "Home Owner" is defined as follows: Person(s) who owns a parcel of land
on which heishe resides or intends to reside, on which there is, or is intended to be, a one or two family dweilin , attached
or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in
two-year period shall not be considered a Home Owner.
If you are applying under this section sign below:
Signature
Your signature carries certain responsibilities, including but not necessarily limited to, general liability
sssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssss:ssssss::ssssss**ssssss*s*sssssssssss
NOTICE TO LICENSED CONTRACTORS: The Building Code provides in the Rules and Regulations section that any
licensed Construction Supervisor, whether or not they have taken the permit are responsible for code compliance. (see
2.15.2 of section 5)
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1500 COST
Cost of Improvement
Items to be installed but not included in the above cost:
TOTAL
Electrical S N A
Plumbing N
HVAC
Other /JA
$
Demolition'- describe structure
Number of dwelling units Number of bedrooms A separate Refuse Disposal
Declaration required.
Moving - (Provide copy of D.P.W. moving license) Type of structure
from where (plat/lot or address)
to where (plat/lot or address)
Number of dwelling units Number of bedrooms per dwelling unit
.= Re -roofing - (for existing only, is included in new construction)
Number of square feet
Number of layers when complete
A separate disposal declaration REQUIRED
Number of layers already existing
= Replacement doors and windows - (for existing only) (only where doors and windows exist and will not be
enlarged) EGRESS dimensions must be maintained. Enlarged or new windows in an existing dwelling will be
considered as an Alteration, otherwise will he included in new construction. (see Code section 3401.10 for
residential and Article 8 f�_ .~,ommercial) =
Temporary structure - includes when allowed, trailers, tents and the like and only for limited periods of time.
Describe
500 CONSTRUCTION PLANS
None submitted. Why?
= Submitted, usually three sets required. Four sets for food service uses. Number of sets submitted
600 SITE PLAN
❑ Not required, why?
Submitted When? - Previously, date C With this application
700 UTILITIES
Water supply required _ yes _ no, public ? _ yes _ no, on site well? _ yes _ no,
existing? _ yes _ no
If required and not existing have necessary permits been issued? _ no _ yes, date
(M.G.L. Chapter 40, section 54 provides that no building permit may be issued unless a water supply, when
required, is available. See Code 780 CMR section 114.1.2)
Sewage disposal - required'_ yes _ no, public sewer _ yes _ no
private septic - on -site _ yes _ no. Submit copy of permit as soon as available.
Z
800 MECHANICALS & PRIMARY FUEL
- Furnace (hot air) - Fuel gas (natural or propane), fuel oil, electricity, other (specify)
A=chctect�Engineer - project supervision and reports
Company name
Boiler (heating)- Fuel gas (natural or propane), fuel oil, electricity, other (specify)
HVAC (combined unit) - Primary fuel, natural gas, propane, electricity, other (specify)
Air conditioning - (separate unit)
1-1 None of the above to be provided
Hot Water Gas Electric Fuel Oil Other
900 SPRINIO.ERS - FOR STRUCTURES OVER 7500 SQUARE FEET and certain multifamily residential
Required, -plans provided, plans not provided, why?
- Not required, not to be installed, Why?
1000 REQUIRED OFF-ST7 • PARE NG - for ZONING &Architectural Access
- NOT APPLICABLE
Parking Plan submitted To - Building Department -; Planning Board Date submitted
Number of spaces - indoors outside total provided
H-ndicap spaces - required _ yes _no. If yes, how many as a p?rt of the total required number.
Is Route 6 (State Road) Entrance permit required? yes 7 no -. If yes has it been issued yes - no -.
Submit copy of application and/or permit as soon as available.
1100 IDENTIFICATION (print or type except as n/otedd))j C/
Current owner name �-, y J r" �" `
address
JJ
phone #
If corporation, officer in charge
ArchitecVEngmeer - for overall design
Company name
Address
Phone number
Certified by State of Massachusetts as
Certification number
NOTE Signatures and seals on all plans, affidavits and other documents SHALL BE originals and not
reproductions.
Address
Phone number
Certified by State of Massachusetts as
Certification number
NOTE Signatures and seals on all plans, affidavits and other documents SHALL BE originals and not
reproductions.
General Contractor (if Homeowner, state homeowner here then complete section 1300)
Company name l C�0 �i e i1161ID S
Address / 1 J k7 fY�W 1� 1 S� /Yj J?d z 7 y 0
Phone number 7 / D — 9y 70 14,-
Construction Supervisors license number GS 73 9-
NOTE Signatures and seals on all plans, affidavits and other documents SHALL BE originals and not
reproductions.
1200 FOR RESIDENTIAL REMODEL WORK ONLY
Are you a Home Improvement Contractor subject to (780CMR - 6) ? Yes _ No _ If no go to next section!
Are you claiming exemption from the requirement? Yes No Zf yes, submit the required affidavit!
Ren_odel contractor name (please print) f-ti'% I't �.S
Address A i i.7 ra w N e.11 s Al13-
Registration number (if none state "none") I adc% s1
Phone number r6$ — c 7 o— / 8 9 0
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE
GUARANTEE FUND! QUESTIONS OR COMPLAINTS call or write:
Home Improvement Contractors Registration
One Ashburton Place - Room 1301
Boston, MA 02108
(617) 727-8598
r
XOwners name (print)
Signature
Date 1,jC^Z
Double Insulated Enviro Class A Stealth
Reverse Cone -Rain Cap Rain Cover
Lam— Storm Collar—� —�
op Support Clamp
late
r
.a
kE
Super Vent Stainless
Steel full retrofit
rehab.
Super Vent Stainless
Steel Rumford Smoke
Chamber full Retrofit
recommended
flue cap
l Ph
existing flue
and damper
L_
Cera-foil
insulating
blanket
1202°-178°F r
1
-engineered to save construction c(
)stly construction mistakes. An
asonry';chimney built ''around =the B
rebox and special masonry smoke d
modular soconstructions-is fa
..oduces an extremely safe, efl
replace every time. The same fire
e above Repair Unit, with.the additi
'wide Rumford style Venturi throat
noke chamber' incorporating' a ret
Narrow
Rumford
Venturi
Throat
98°F
90°F
82°F
80°F
L
� ������;.•_ •� era)
L
y
SLEEPY HOLLOW
CHIMNEY SUPPLY LTD.
85 EMJAY BLVD.
BRENTWOOD, NY 11717
(516) 231-2333 FAX (516) 231-2364
THE BELLFIREO FIREPLACE SYSTEM
The Rosin fireplace system was scientifically developed in Europe. It debuted from
the laboratory as the Bellfire TM fireplace by Mr. Bell of England, a contemporary of Dr.
Rosin. It was commonly used to heat the complete home until the second World War.
Since then it has been further developed by using more modern aerodynamic con-
cepts and thermal insulation techniques to improve the design.
The BELLFIRE® fireplace is essentially a firebox composed of three components, all
precast in refractory materials. These components are the fireback, the hearth, and
the side flares. The unit is designed in a half -pear shape in order to give the greatest
efficiency possible.
In new construction or a complete retrofit with a full stainless -steel chimney liner, there
is a fourth component added which provides the system with a performance rating
comparable to many of today's high-tech woodstoves. This fourth component is a
stainless -steel or refractory dome fitted with an adjustable damper.
1. The half -pear shape design ensures a smoke -free home environment. Very little air
is required to maintain a clean bright fire which results in little heat loss from the
house up the chimney, and a draft -free room.
2. Minimal draft in the room means more than twice the heat and half the waste of
a conventional fireplace. The result is a high overall efficiency rating and low emis-
sions.
3. The half -pear design radiates and reflects heat back into the room and the fire.
The BELLFIRE® burns wood better, easier, and more completely than the conven-
tional fireplace. Radiant heat leaving the BELLFIRE® firebox has been measured in
excess of 4500 F, and room temperature increases of 150 within an hour are not an
uncommon occurrence.
4. The BELLFIRE® will use at least 50% less wood than the common masonry fireplace,
and if "banked" right will radiate heat overnight and hold enough hot coals to be
rekindled the next morning.
5. No electrical fans are required to drive the heat into the room. This conserves elec-
tricity while providing the same kind of radiant warmth that we get from the sun.
6. Additional features and advantages:
a) The BELLFIRE® liner is the only insert that does not alter the aesthetics of the open
fireplace.
b) The BELLFIRE® liner fits most fireplaces.
c) The BELLFIRE® can be installed economically with no mess or reconstruction.
d) The insulated refractory material radiates heat much better than metal and
retains heat much longer after the fire is out.
QUESTIONS COMMONLY ASKED
Q. Will a BELLFIRE° provide heat like a metal air -circulating fireplace?
A. More so. A BELLFIRE° will provide ample heat without the grills & fans. The spe-
cial refractory material of the Rosin Design radiates a comfortable warmth into
the room. This type of system has been used in Europe for over 55 years.
Q. What kind of material is used to manufacture the BELLFIRE° system?
A. The material used is the same as that used for industrial furnaces: i.e. a refrac-
tory castable, completely fireproof to 30000 F, and it will never rust out! BELL -
FIRES° are cast with a 70% alumina refractory, reinforced with stainless steel
needles.
Q. From the heat produced, do any parts of the unit crack?
A. Hairline cracking is normal with refractory castables. The safety, efficiency, and
longevity of the unit is not affected. Hairline cracking can be minimized by
starting out with several small fires.
Q. Is a metal grate necessary?
A. If the BELLFIRE° is installed without the refractory hearth, then a metal grate
could be used. Optimum efficiency is accomplished by building the fire direct-
ly on the special refractory hearth. When using a metal grate, you elevate the
wood thus drawing more cold air into the firebox and cooling the temperature
of the fire. The BELLFIRE° burns wood completely, not only increasing the effi-
ciency of the fireplace but also reducing the formation of creosote.
Q. What about an ash dump?
A. Because of complete combustion, the resulting ashes are very fine and are
easily cleaned out. No ash dump is required.
Q. Why does the BELLFIRE° draw so well?
A. The aerodynamic design of the Rosin Design has been completely and care-
fully calculated to provide a fireplace system that, when combined with a
properly constructed chimney and adequately balanced room pressure, will
not smoke.
Q. Why is the BELLFIRE° firebox so shallow?
A. The BELLFIRE° appears more shallow than it really is. A typical installation, in new
construction, has a finished depth of between 19" and 23", and a width of
around 36".
Q. Can you burn coal or other fuels in a BELLFIRE° fireplace?
A. The BELLFIRE° fireplace is designed to burn wood. To burn coal, a special metal
grate would need to be added. This was popular during the 1940-1950 period.
BUILDIN
Handv Items to Have
A Fireplace Screen
A Kindling Ax (Be careful)
Stove Gloves
An Ash Rake
THE WORLDS BEST FIRE
FRED SCHUKAL AND CHRIS PRIOR
Think of your fuel load as three
component parts:
The Base Course (can be
unsplit if proper diameter)
The Middle Course (split)
The Top Courses (split finer)
A fireplace grate is not neces-
sary with the above. A grate
increases your critical burn
rate allowing logs to burn
faster than normal. Logs burn
best in contact with hot fire-
brick in a bed of wood ashes.
Helpful Hints & Precautions
before you start:
Make sure your fireplace and
flue have been inspected for
fire worthiness and are
cleaned if found dirty (full of
flammable cresosote), by a
reputable Chimney Sweep.
Make sure damper is open. If
none is present have a top
mount version retrofitted. The
retrofit is a tremendous energy
saver and assists in keeping
out animals, noise and pollu-
tion. If your fireplace and flue
are located on an outside wall
or when the damper is open
and you feel a flow of frigid air,
pre -heat the flue with a sheet
of lit newspaper. Hold high into
the damper area, wearing a
pair of stove gloves for protec-
tion. This will reverse the cold
air plug present in the flue, cre-
ating a strong updraft with no
smoke into your room. As soon
as the above is completed
light your newspaper on top of
your fuel load. Approximately
3-4 hours later when you have
a nice bed of hardwood
coals, use a fireplace rake to
push the coals against the
rear wall of the firebox. Next,
lay your new logs, minimum of
four, on top of the hot coals,
lay the bottom two horizontal-
ly. The top two, a little shorter in
length, place front to back
approximately 3 inches apart
creating a throat.
The greatest volume of smoke
and particulate pollution from
a wood fire occurs during a
cold start up. Wood fires lit
from the bottom, in a conven-
tional manner, promote a dirty
burn and waste a large
amount of potential heat in
the form of unburned gases.
A clean and efficient method
for kindling a fire is a top burn.
This almost forgotten ancient
European technique places
the largest wood at the bot-
tom in a criss cross crib fashion.
As each tier is laid, the criss
crossing becomes smaller.
Kindling and a small amount of
paper are placed on top and
lit.
When the top burn fire is lit, the
flames are always above the
fuel load. The smoke and flam-
mable gas from each tier of
wood will always travel up
through the flame and burn,
thereby reducing particulate
pollution and unburned fuel.
A top kindling fire also pro-
duces large and less com-
pacted glowing coals, provid-
ing excellent long-lasting radi-
ant heat.
A top burn fire laid with sea-
soned hardwood to a height
of eighteen to twenty-four
inches will burn approximately
four hours without adding
additional wood. The fire will
be mesmerizing as each tier
slowly ignites and burns its way
down.
TOP BURN RECIPE
Always start with dry, well -sea-
soned, split firewood and kin-
dling. (Ideally seasoned fire-
wood will have a 20% moisture
content. The wood will show
radial cracks at the ends and
sound like bowling pins when
beaten together.)
Bottom layer:
Three good sized pieces of split
hardwood five to six inches
thick, laid front to back.
Second layer:
Three slightly smaller pieces of
split firewood three to five
inches thick, laid side to side.
Third layer:
Four to five smaller pieces of
split firewood two to three
inches thick, laid front to back.
Keep alternating and decreas-
ing in size with split hardwood
until they are about one inch
thick.
Now alternate two rows with
split softwood (pine, spruce,
etc.) until pencil thick. Place a
small piece of newspaper on
top and light.
This article is intended to help
your customers understand
and benefit from the knowl-
edge chimney professionals
offer.