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BP-95337 TOWN OF DARTN UT`-I- BUILDING DEPARTMENT RECEIPT 95337 PHONE: 508-910-1820 FAX: 508-910-1838 Name: r ;r -, ' '' t. _ Property Owner: ` Data , Job Location: ', f . '. , Map: Lot li Description General Ledger#'s Ref. #` Amount Building& BuildingMisc. 01000-44105 0`-' , �'� ; a Electrical 01000-44106 T 1 Plumbing & Gas 01000-44107 �, ' Trench Safety 01000-44129 Other Department Revenue 01000-42420 �'�n1 n o w�s.s� White-Collector's Office Yellow Copy-Customer's Receipt Pink Copy-Building Department Received By , .-/ THIS IS NOT A PERMIT/LICENSE FOR BUILDING, ELECTRICAL, PLUMBING OR GAS RESIDENTIAL ❑ Phased Approval(R1064.3) -44 $25.00 APPLICATION FEE IS NON RE-FUNDABLE &NON-TRANSFERABLE DATE RECEIVED `,oUTH'„"4 DARTMOUTH BUILDING DEPARTMENT 400 Slocum Road, P.O. Box 79399 ,if4R • � , Dartmouth, MA 02747 24 '� 33 y q .,664 ; Phone: 508-910-1820 Fax: 508-910-1838 www.town.dartmouth.ma.us APPLICATION TO CONSTRUCT, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING THIS SECTION FOR OFFICIAL USE ONLY RECEIVED BY: a BUILDING PERMIT NUMBER DATE ISSUED: SIGNATURE: /% '/ DATE: , ____1 Building Commissioner/Inspector of Buildings Zoning District: See 3 Proposed Use:— se- G \ Zone: ❑ B 0 A 0 V Aquifer Zone: .-'"----- THE FOLLOWING AGENCIES SHOULD BE NOTIFIED: i i ❑Board of 0 Board of 0 Cons. 0 Demo , CI davit 0 Elec. 0 Energy Report Appeals Health Commission Affidavit / Card Sent: Cut Off Follow-up* i ❑Fire 0 Gas 0 Planning 0 Sewer Card 0 Water Card ❑Zoning ❑Other Chief Cut Off Board Cut Off Cut Off ` *REQUIRES INSPECTOR'S REVIEW BEFORE THE ISSUANCE OF A PERMIT. DEPARTMENTAL APPROVAL -4 Board of Health: Signature: Date: Conservation Commission: Signature: Date: Other: Signature: Date: Signature: Date: Signature: Date: Brief description of work being gPerformed: Rzv14i� �x:',-,,E.,..) i ccc,r,i,e a-;cr-\)I0,c-e inSLC') t,,.jtr►4-11Pt.-)rA", SECTION 1 -SITE INFORMATION 1.1 Property Address: -r""pc)e c: (`0 s L.Ih tiJ= 1.2 Assessors Map&Lot Number: Lot Area(sf.) Frontage Map--22_ Lot 6 - 472 Required Provided Front Yard 1.3 Historical District 0 Yes 0 No Side Yard Year Built Rear Yard 0 Altering more than 25%per side of building a 1.4 Water Supply MGL c40 s54): 1.5 Sewage Disposal System: Has application been submitted to the Historic Commission? 0 Municipal Private Well 0 Municipal On Site Disposal System 0 Yes 0 No Date: ti Revised 10/11 0 CONSTRUCTION PLANS ❑ SITE PLAN 0 ENERGY REPORT RESIDENTIAL SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT n 2.1 Owner Record: Name(print) Contact Address Phone Number {t ' 2.2 Authorized Agent: Name(print) Contact Address Phone Number SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor/Specialty License: License Number: "/(C j `( Company Name/Contractor Name: CO,,.,r,..,0 n,,jeol\AAF ce.c\o c �� rzv, `;,\\ Shc S►J Address: I S C i - [vie T'�,� �i��(�L�C L Expiration ateV2G Signature: Telephone: /;) j - 7� _ 2c C G 3.2 Homeowner Exemption-One&Two Family Only Section 110.R5.1.3.1 Exception: FOR HOMEOWNERS WHO INTEND TO PERFORM AND BE RESPONSIBLE FOR THEIR OWN PROJECT Exception: Any Homeowner performing work for which a Building Permit is required shalt be exempt from the provisions of this section;provides that if a Homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor. For the purposes of this section only,a"Homeowner"is defined as follows: Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shalt not be considered a Homeowner. If you are applying under this section sign below: Signature: SECTION 4-WORKER'S COMPENSATION INSURANCE AFFIDAVIT(MGL c 152§25) Worker's Compensation Insurance Affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed Affidavit Attached: t5<Yes 0 No SECTION 5-DESCRIPTION OF PROPOSED WORK(Check all applicable) ❑ Deck 0 Pool 0 Repairs 0 Alteration Chimney/Fireplace 0 Woodstove/Pellet Stove 0 New Construction* 0 Accessory Bldg. 0 Roofing/Siding ❑Other (Energy report required) (Shed/Garage) (Specify below) ❑Addition 0 Replacement window/door 0 Demolition (Energy report required) No. of windows Doors (Specify below) *If new construction, please complete the following: Single Family: No. of Bedrooms No. of Baths Two Family: No of Bedrooms Unit 1 No.of Baths Unit 1 No of Bedrooms Unit 2 No. of Baths Unit 2 „ ❑Furnace(hot air)-fuel gas(natural or propane),fuel oil,electricity,other(specify): ❑Boiler(heating)-fuel gas(natural or propane),fuel oil,electricity,other(specify): • ❑HVAC(combined unit)-primary fuel,natural gas,propane,electricity,other(specify): i 0 Air conditioning-(separate unit) ❑None of the above to be provided 0 Hot Water: Gas Electric Fuel Oil Other SECTION 6-ESTIMATED CONSTRUCTION COST Item Estimated Cost($)to be completed by permit applicant 1. Building i 2. Electrical 3. Plumbing t 4. Mechanical(HVAC) ) 7 ‘' 5. Total=(1 +2+3+4) 3-'; SECTION 7A-OWNER AUTHORIZATION (to be completed when owner's agent or contractor applies for building permit) (Please Print) I, , as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7B-OWNER/AUTHORIZED AGENT DECLARATION I, J o VC clrs AY`11 C•a L ,as Owner/Authorized Agent hereby declare that the statements and information on the foregoing application are rue and accurate, to the best of my knowledge and belief. Signe r the pain p alties erjury. 6,11.-t— 6 3/ i c1/4- G . Sig ture of Ow /Autho ized Agent Date SECTION 8-OFFICE/INSPECTOR'S NOTES �.— Less Application Fee: $25.00� Remaining Bala e: $ Total Permit Fee:$ CJ / 75 Other$Amount$ 7 Gross Area-New Construction total sq.ft. Gross Area-Alteration total sq.ft. J Permit Issued to: �'`f.al to- ,.cam 1''G�, j 'L�.djy. .12,P. / p SECTION 9-ADDITIONAL COMMENTS/SKETCHES Y----0-)Gets/ " L ,G,,jLI A \r`I" \,,J L`) ,-L vv\,\eC',a 0 21&ee.., e deLx)6e_otw c 6: Of 0E1 3 / gild Ai rutia pt,, iecryli Permit No. BP-95337 Project Location: 5 MEDEIROS LN Commonwe ,rr• : sachusetts To 0. .. a t` r • UTH GIS#: 4175.00 e'40t1 �� , � ,r Map: 0079 r417 A Lot: 0006 Sublot: 0012 #�; " ' Category: FIREPLACE '� , � s INSERT ,pro Project# JS-2020-002103 fk a i F` J .t 4 Est.Cost: $5000.00 Fee: $75.00 o -. Const.Class: Contra r „ e: • one#: MIC .�� �' IO k - .17 i 8)958-8965 Use Group: R3 Lot Size(sq. ft.) 48287 Engineer. °� „so .� Phone#: Zoning: SRg �� Aquifer Zone: N/A Applicant: s, 6 Phone#:si Flood Zone: ZONE X JUSTIN A :T.' °$a��4 °0���4essra�+,•��.*� (774)328-1896New Const.: N/A OWNER: Alt.Const.: N/A AMARALJUIN DATE ISSUED: 2/ 2111" TO PERFORM THE FOLLOWING WORK: Replace existing gas fireplace insert per manufacturer's specs DATE TIME TYPE OF INSPECTION&REMARKS INITIAL RESIDENTIAL • SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2,1 Owner Record: �, T -► +R►��. ,,r/nr05-lad3 L 7;y=3 I??C Name(print) Contact Address Phone Number IS u 2.2 Authorized Agent: ii ! Name(print) Contact Address Phone Number SECTION 1.-CONSTRUCTION SERVICES t- -Olg51-7 `55 • 3.1 Licensed Construction 5u rvisorlS cial License: License Number: / rc �{ Company Name/Contractor Name: �, ,, ispra���, �A C sa Address: 451 C A- N lam_�T F �'G QL/')C Expiration ate: Signature: Telephone:7 J ` X 2- Zo88-_ C o V7C 3.2 Homeowner Exemption-One&Two Family Only Section 110 R5.1.3.1 Exception: FOR HOMEOWNERS WHO INTEND TO PERFORM AND HE RESPONSIBLE FOR THEIR OWN PROJECT Exception: Any Homeowner performing work for which a Building Permit Is required shaft es exempt from the provisions of This section:provides that if a Homeowner ; engages a person(s)for hire to do such work,tel such Homeowner snail act as supervisor. • For the purposes of this section only,a"Homeowner"he defined as follows: Person(a)who owns a parcel of land on which heist*resides or islands to reside,ore which { there is,or Is intended to be,a one or Iwo family dwelling,attached or detached sructures accessory to such use artdior farm structures.A person who constrocls more then one home In a Iwo-year period ghee rot be considered a Homeowner. if you are applying under this section sign below: Signature: • • SECTION 4-WORKER'S COMPENSATION INSURANCE AFFIDAVIT(MOL c 152$25) • • Worker's Compensation Insurance Affidavit must be completed and'submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed Affidavit Attached: (S<Yes C3 No • SECTION 5-DESCRIPTION OF PROPOSED WORK(Check all applicable) 0 Deck 0 Pool O Repairs IT Alteration Chimney/Fireplace CI Woodsto, eliet Stove CI New Construction* 0 Accessory Bklg. 0 Roofing/Siding ❑Other 21, (Energy report required) (Shed/Garage) (Specify bee CI Addition LiReplacement window/door 0 Demolition (Energy report required) No.of windows Doors (Specify below) 2 if new construction,please complete the following: W' Single Family: No.of Bedrooms No.of Baths Two Family: No of Bedrooms Unit 1 No.of Baths Unit 1 No of Bedrooms Unit 2 No.of Baths Unit 2 0 Furnace(hot air)-fuel gas(natural or propane),fuel oil,electricity,other(specify): O Boller(heating)-fuel gas(natural or propane),fuel oil,electricity,other(specify): CI HVAC(combined unit)-primaryfuel,naturalgas,propane,electric other a electricity, ( peciry): CI Air conditioning-(separate unit) O None of the above to be provided ❑Hot Water: Gas Electric Fuel Oil Other • ■ AC D® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYIr) 03/18/2020 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Laura Wiesner NAME: C&S Insurance Agency,Inc. PHONE )_ (508)339-2951 FAX No): (508)339-4811 190 Chauncy Street/P.O Box 406 E-MAIL laura@candsins.com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# Mansfield MA 02048 INSURER A: Ohio Security Ins Co 24082 INSURED INSURER B: West American Ins Co 44393 Commonwealth Fireplace And Grill Shop Inc INSURER C: The Ohio Casualty Ins Co 24074 151 Carnegie Row INSURER D: INSURER E: Norwood MA 02062 INSURER F: COVERAGES CERTIFICATE NUMBER: 2019-2020 Master REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTRINSR TYPE OF INSURANCE INSD DL y VD POLICY NUMBER POLICY EFF POLICY EXP LIMITS (MM/DDlYYYIf) (MM/DDMlYIr) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCEDAMAGE T $ 1,000,000 RENTED CLAIMS-MADE X OCCUR PREMISESO(Ea occurrence) $ 300,000 - MED EXP(Any one person) $ 15,000 - A BKS57853696 04/07/2019 04/07/2020 PERSONAL&ADVINJURY $ 1,000,000 GEN'LAGGREGAATEE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X JECT LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ B OWNED XI SCHEDULED BAW57853696 04/07/2019 04/07/2020 BODILY INJURY(Per accident) $ AUTOS ONLY /� AUTOS XHIRED �/ NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per ac'dent) $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 C EXCESS LIAB CLAIMS-MADE US057853696 0' 17/2019 04/07/20 AGGREGATE $ 5,000,000 DED X RETENTION$ 10,000 / $ WORKERS COMPENSATION �° /� STATUTE EOT - RH AND EMPLOYERS'LIABILITY y/N C ANY PROPRIETOR/PARTNER/EXECUTIVE N NIA XW057853696 04/07/2019 ,r 4l07/2020 E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) / E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ / io DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Justin Amaral ACCORDANCE WITH THE POLICY PROVISIONS. 5 Medeiros Lane AUTHORIZED REPRESENTATIVE Dartmouth MA 02747 I dQa:iL I,uIona-() ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD � l ®AC 0 CERTIFICATE OF LIABILITY INSURANCE DATE(MMlDD/YYYY) 04/15/2020 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Laura Wiesner NAME: C&S Insurance Agency,Inc. PHONE Ext): (508)339-2951 FAX,No): (508)339-4811 190 Chauncy Street/P.O Box 406 E-MAIL laura@candsins.com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# Mansfield MA 02048 INSURER A: Ohio Security Ins Co 24082 INSURED INSURER B: The Ohio Casualty Ins Co 24074 Commonwealth Fireplace And Grill Shop Inc INSURER C: 151 Carnegie Row INSURERD: INSURER E Norwood MA 02062 INSURER F: COVERAGES CERTIFICATE NUMBER: 2020-2021 Master REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADM_SUBIZ POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,DAMAGET000 RENTtU CLAIMS-MADE X OCCUR PREMISES O(Ea occurrence) $ 300,000 MED EXP(Any one person) $ 15,000 A BKS57853696 04/07/2020 04/07/2021 PERSONAL aADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X PRO LOC PRODUCTS-COMP/OPAGG $ 2,000,000 J ECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ A - OWNED X SCHEDULED BAW57853696 04/07/2020 04/07/2021 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED �/ NON-OWNED PROPERTY DAMAGE AUTOS ONLY /� AUTOS ONLY (Per accident) UMBRELLA LIAB X OCCUR EACH OCCURRENCE 5,000,000 B - EXCESS LIAB CLAIMS-MADE US057853696 04/07/2020 04/07/2021 AGGREGATE 5,000,000 DED X RETENTION$ 10,000 WORKERS COMPENSATION X STATUTE EORH AND EMPLOYERS'LIABILITY Y/N BANY PROPRIETOR/PARTNER/EXECUTIVE N N/A XW057853696 04/07/2020 04/07/2021 1,000,000 OFFICER/MEMBER EXCLUDED? E.L.EACH ACCIDENT (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Justin Amaral ACCORDANCE WITH THE POLICY PROVISIONS. 5 Medeiros Lane AUTHORIZED REPRESENTATIVE Dartmouth MA 02747 • ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Commonwealth w Massachusetts Division of ProfessionalLcens Board of Bulidmg Regulations and Stant,- CSFA-099517 Exprzs, 11.04/2021 MICHAEL B DURNIOK 60 NEEDHAM ST NORFOLK MA 02056 Commissioner cton Office of Consumer Affairs and Business Regulation One Ashburton Place - Suite 1301 3oston, Massachusetts 02108 Home Improvement Contractor Registration Type. Supplement Caro Registration: 166554 CCMMONWFA TH SHOP 1%C_: ExCiratiOn. 0608202, 15, CARFC...iE NORW 00 D MA .:aoate Address and Return Card Office of Consumer Araars Bust egs fle9tvattor, HOME IMPROVEMENT C A OR Registration valid for,nctivioual use ono, TYPE: before the exportation date If found return to filgsvratIon xpirahon Office of Consumer Affairs arid Business Regutatfor r. One Ashburton Place-Suite 1301 Boston.MA 02108 Not valid without signature fanner DEBRIS DISPOSAL AFFIDAVIT In accordance with the provisions of M.G.L. c. 40, s. 54, Building Permit # was issued with the condition that all debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by M.G.L c. 111, s. 150A. The debris will be disposed of in: Republic Waste Services Name of Waste Facility jCOPY L ~u 151 Carnegie Row Norwood, MA 02062 Address of Waste Facility 1 l l-5 Debris: As a condition of issuing a permit for the demolition, renovation, rehabilitation or other alteration of a building or structure, M.G.L. c. 40 s. 54 requires that the debris resulting therefrom shall be disposed of in a properly licensed solid waste disposal facility as defined by M.G.L.c. 11 l s. 150 A.Signature of the permit applicant, date and number of the building permit to be issued shall he indicated on a form provided by the Building Department and attached to the office copy of the building permit retained by the Building Department. If the debris will not be disposed of as indicated, the holder of the permit shall notify the building official, in writing,as to the location where the debris will be disposed. 780 CMR—6t° Edition ,-;77:7 ''- - / ' 1 Signature of Permit Applicant 05 k ci 0 Date .t i q 2 w 71te t ortrrno►nweult/r o f':'t'lass1k/ittsetts "tl ': 1 1 Department of Industrial Accidents i Office of investigations rttiorts t 6f10 Washin;ton Street Boston, Mass. 02111 www.mass.gsei v/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name il3usinessOreaniration lneisiduat) Commonwealth Fireplace Address: 151 Carnegie Row City/State/Zip: Norwood,MA 02062 _ Phone#: 781-762-2088 ire you an employer?Check the appropriate lox: Type of project(required): I. 2(I am an employer with 11 =i. I air,a general t liacu,r old I G_ New construction employees(Pull and or part time).: ha,,,,,hired The sub-:-, 11traCtOrS 7. Remodeling 2. i am a sole proprietor or partner- listed on the attaclIcrt sheet. ship and have no employees I;test sub-contractors have 8. Demolition ‘vorkina far me in any capacity. emplo.)ecs and have workers' 9. Building addition t o workers'comp.insurance ..:,:a ip i sttizan e. : required 5.; We are a corporation thin and its j 10. :Electrical repairs or additions 3. I am a homeowner doing all work f 11s_Ct.s have ae bed their ; myself. [No workers'comp. rl l.t or cacnra€iot issrm N1Cii, I i. Plumbin_repairs or addi;ii,n insurance required].,; Q. 152.: I t-t'i.and ,e have no � 12. - Roof repairs employee, In r workers'rs ;( ' _, X(titter Ortal TR90 l citntp.insurance required.] i - _ __.. >__.._...T.._..,.. I *Any applicant that checks brit uI must-also fill out the section h-i bowing their s;rttcrs'compensation police ittfnrtnation. ---- , Stiomeossners who submit this affidavit indicatinog they are doing;all wart:and then i:ire outside contractors must submit a new affidavit indicating sueh. :Contactors that check this box must attach an additional sheet show ing the name ofthe sub-contractors and state whether or not those entities hart einid„rees, If the sub-contractors have employees,they must pros ids they s orr.e rs's mp .m,Iies'number. I:am an employer that is providing;it'orkeFt•compensation'insurance JOY nit'einplot,ea. Below 18 the policy and jtlb.sue information. insurance Company Name: Peerless Insurance ^^iNCt341202g 04/07/2020 Policy or Self ins.Lie. - Expiration xpirz�tiitn Date: Job Site Address: 5 Medeiros Lane city state lip: Dartmouth, MA 02747 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration(date). Failure to secure colcragc as required under Sc_,_. 1`i 2.a of'./A(-i_ 152 can lead to the imposition of criminal penalti ..0I a line up to S 1.500.00 and/or one Year imprisonment as`:'cil as cis ii 7cne Chas in the form of a SI OP WORK ORDER and He of $250.00 a day against violator, Be auvised tl'wq a e.p—. or this s atciii 111 maybe forwarded to the Office of In\estigation of die- DIA for coveraece verification. t do herby certijt under the pat►tS•aid penalties of pry'jug that the information provided above is true and correct. signano-e: f'` jr. 3/19/2020 Print �arrre: Bruce C. keltie 781-762-2088 I Official use only Do trot write in this area to he comp/etee by city'or town official I City or Town: ----___ __.. - __,__.-__I'ertnit/license#: j Issuing Authority(circle otte): 1.Board of Heath 2. Building Department 3.(_its I own Clerk 4. 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E tL s L ti ° ��`� _ o x �a wwC7 ca vs 0, q C �W U u .s- .L" v U o 0 0 o w E� T Oa ^ .- . 0 o• °) o .o o °3 0 0 .a) a`3 ai v w is • • 0 i o 1- U c/), g W V1 � t7v) Owwe4r1SI I I = xdE° °- E- HHa1xvw, dcnC7o� -.�� cawwww Page 1 of 5 IT,L,LJ YOUR LIFE, YOUR FIRE 90-110 Traditional Framing Information w Cl GF-w 11_ o o ill o=i i=izi '' .❑ . 7 .. , 7, �,'Gal r _Ao IJ r� _ .7�i 'c• .• •e•.• ._. Front View Left Side View 2' ®Oo s aar0moo A t �� I 4. 44 a.p Ea VVV Top View # (H) (W) (D) Glass Opening Model Height Width Depth C1 C2 C3 (GF) Front (GS) Side 90 37%" 401%6" 25 X6' 7%" 20 3/" 18 Ys" 35%s'W X 31 5/"H 110 40 1 16" 48%6" 25 ys' 7%" 24 Y" 18 X6" 421X6"W X 34 y"H *Dimensions includes Y2"lip (for drywall) Note: 1.Drawings are not to Scale 2.All dimensions in inches Page 2 of 5 RTC-.H YOUR LIFE. YOUR FIRE 90-110 Traditional Framing Information Standard Frame _...„,,,,,...1..,••'"""'''''' .........,,,,, ,1 .1 .....•0 0............... ... ,.... .../j•; wood studs Steel Studs F-,---....„--..--•-• 67 Ye ----_ A Cam_ Vie- `r /6 Model A B C D 3 /-_ 90 29 Ya" 46�s 27/s" 10 110 26 Ys" 53 9k" 27 s" 10" ,� 3'� li nterlor 5J8"Type X c �` (bald interior 5/8"Type X Exterior 5B"Type X LEGEND Note: 1.Drawings are not to Scale MI �"Type X steel ( I wood 2.All dimensions in inches r/ .�I Glass ® wood surds r] Steel Studs Page 3 of 5 RT--,LJ YOUR LIFE,YOUR FIRE 90-110 Traditional Framing Information Standard Frame 5/8'Type X .Iiii'lir „, , Wood Studs / 1T II II 1) ( - •- Heat Release:124 sq.in. _5/8"Type X 5B'T .1 on Inside YPe Wood Studsli ii 1 Al I kI T " I Steel Studs '%/ // °/' %•'i — -- try • �m= / // // // I �I f!j�/j/i , , , GHI ,, , /i / /i ! I 1 - _,„ - , - / . c, ____ ___4__,i .••• View B views Add Drywall nailer as needed maintain 2" clearance to any part of Model T GH Fireplace "Is zs 90 4 3/a" 31 %" 110 5 Xs" 34 Y" ® � — Clearance 2"from each side to non combustible J I' material No access panel required Top View for TR series.Gas/ electrical components are Note: 1.Drawings are not to Scale located on the left side of the unit and are accessible 2.All dimensions in inches through the left interior panel of the fireplace. Page 4 of 5 R TILJ YOUR 90-110 LICE. YOi1R t IRE Traditional Framing Information Corner Frame '�. - D � —wood Studs Steel Studs MI INN it ir„ A --`'S— /� B � 0 Viewer Model A B D 90 29 Y4 46 Yls' 10" 110 268' 53%s' 10 Interlor5/8"Typex az. (bac- I 4 ,III interior 5/8"Type X i s Exterior 5/B'Type X LEGEND Note: 1. Drawln�s are not to Scale 56•Type x steel wood 2.Al.dimensions in inches r/ .1 Glass ® Wood studs n steel studs Page 5 of 5 RT 1_, YOUR LIFE.YOUR FIRE 90-110 Traditional Framing Information Corner Frame • 1 r----- •• -- , Heat Release:124 sq.in. -5/8"Type X "T �' on Inside �' STI Wood Studs I' AI 5:1 Steel Studs _,4 . .. . .. ===, ,.... ,;/////7.,/,...-: ---1` ,.'-: 1 -• I ID /////// / i V / / / // GHI F // //.//j/// I 1 = 4 • I / // _// / ./j View I Add Drywall nailer as needed maintain 2" View B clearance to any part of Fireplace A Clearance 2"from each side to non 0 0®oO!?D . IEN are located on the left side of the unit and are accessible through the left A"ME IiiM Mtr.,70.11':'\ interior panel of the fireplace. X Model X Y Z E T GH Top View 90 108" 75%" 30 y" 23 y" 4%" 31 %" Note: 1.Drawings are not to Scale 2.All dimensions in inches 110 114 3/" 80 Y2" 34" 27" 5 Y1s" 34 Ye" y , . ,, , „, ..., .,.. -...t ,,, , Iir , / f„, — --*- - s' , „ DAL SIN LI . t � t �' ? e ' = � l a r� � ' ,e � __...‘-..........!r f i x ‘,./ i .1.14‘,41 k, ,1 x.. , Aix bill t, 4 Light Stainless Flexible Liner "Dalsin Line"® light flexible liner is listed for chimney relining and is suitable for wood, pellet, gas, oil, and coal applications. This liner is manufactured using .006" thick Type 316L stainless steel and backed by a limited lifetime warranty. All components are made from Type 316L stainless steel and are designed for quick and easy installation. Key Features Low-Profivi Low VisibilityleTermination But High PerfProormadesnce Professional Grade Materials Provide •A stamped design provides finished a earance Ultimate in Safety and Performance mow Mitt •Man otheptermination styles for a Lifetime 1 Y •All flex system components are made from available 24 gauge,type 316L Stainless Steel •Entire flex system is warranted for life "` ` •U.L.and U.L.C.Listed to UL1777 standards for chimney liner � • �,� �,� Mass. Approval G1-0216-340 i . Fast,Fastener-Free Installation Ultimate Liner Construction Provides •All components have factory integrated stainless Lifetime Durability and Safety steel hose clamps for safe and strong connections i •Made with.006"or.005"thick,type •No tools or fasteners needed for installation l 316E stainless steel ; •Professional grade materials make liner ideal for multiple liner applications Strongest Liner on the Market -",- " Legend •Made with the thickest materials in the"light" flex category Q Copper Coating Available •The locking seam in production process is the `� r Black Powder Coating Available strongest in the industry and wi l not come apart. ` - Packaged Quantity Per Carton Packaged Cartons Per Pallet Custom Ovalizing#98990001 800 729 9505 651 460 6080 fax sales@dalsinmfg.com www.dalsinmfg.com 37 Applications DALSIN LINE Or Low Profile Flex Rain Cap 0 S Low Profile Flex Rain Cap P43 • Low Profile Flex Rain Cap go a\�� S.S.Flex Support Plate ' S.S.°�� Flex Support Plate •' S.S.\�% Flex Support Plate \�s�rj`g �±��0 s \\e00.', ® =pi \® r r a/ S.S.Light Flex Liner 0 1 S.S.Light Flex Liner \r v +/ S.S.Light Flex Liner +e„ ao erj ii \/ a a-/ ;% a °a/kro,:� i *, 0i .. 0 �� , � Foil Tape \a ` ®� 46 r v a� a�i/ S.S.Wire Mesh N., / Two-Piece Flex Tee ! \r «r ®o a•%Or � a/ \a ®/ Universal Flex Connector o t%a� v ,� Tee Branch Extension 0 ii � a/ a a%\r = :% (optional) tk -if .. s am \r `Sr \-' j/'� Masonry Chimney % 0� S.S.Hose Clamp 0 ;;��s/� Masonry Chimney a a\®\'%C�� Decorator Collar , �j a\\��0( Decorator Collar tktiCr�, 1 r ® ao S.S.Light Flex Liner ' 0\\0 �1 Ij, i®\\0/� S.S.90°Elbow P 54 9 r r 9 a Oglrik . S.S.90°Elbow ,\\\r/// r�~ q� \\r/bra° \ \0//r '� . o, e/ \\ a/ m \\�ca/ S.S.Liner \ 1�J 404po: S.S.Liner® ;\\�j®®� ``\V `- \$ /®®01 Agge015 ..�� /< S.S.Appliance ;®\��(54 a A 0* \\\s /j \�od�%® Connectors ,41.1110 !\®`r//4 4 --r;j- ,\\~i/i0 %SOP N, ----,. .01- _„,0,0, Stove Vertical Appliance to Chimney Fireplace Insert with Termination Termination Insulation Termination 4W Low Profile Flex Rain Cap 12 ®®�� S.S.Flex Support Plate 0 olel ' S.S.Light Flex Liner e a`/ i . o% sa "/ s a q� ii,C 4'0 \ g a%'0 - i% i0 , 1, a/ ate/ i of ;J_ v0 Appliance Connector S s '\�%/`0 !w4 \® /- AllComponents,� � \\�// forinsert1 \I \\0®/ installations aref \��/ 'Sntainlne ds Steel \r Flex Connector Kit" Fireplace Insert Termination 38 800 729 9505 651 460 6080 fax sales@dalsinmfg.com www.dalsinmfg.com Build-Your-Own Kits DALSIN LINE (SS Flex Connector Kit) - � 1 BDM will assemble a kit just the way you want it! Simply pick the length :e of liner you need and then choose from the different cap, support plate _ and connector options below. Call BDM today for pricing and to place your orders Standard kits available on page 40. ye . 0 tes Standard Kit Kit Options x SS Flex Liner Choose a length `: 15' 18' 20` 25' 30': 35' ; Choose a size or 55 � 3" 4" 5" . " 6" 7" 8" ig Low Profile Cap Choose a cap r Round w/Screen(Add:SC) Round (Add: RC) Square w/Hinge(Add: HC) w k . or ;, s' .. 0 v Add the above letters at the end of the SS Kit part number for fireplace style cap. il Choose a support plate if 4% `j lg 9"x9" 9"x13" 13"x13 13"x18"' 16"x16" 18"x18" 24"x24" t Or.` o Universal Connector Choose a Connector Stove Connector Insert Connector 30°or 45°Elbow Offset Adaptor tile J '� or . Call for pricing on our Build-Your-Own kits and to place order. Other sizes/options available - call BDM for more information. 800 729 9505 651 460 6080 fax sales@dalsinmfg.com www.dalsinmfg.com 39 Light SS Flex Liner DALSIN LINE s _ Stainless Steel Flex Connector Kit(Type 316L) - Size Order# Order# t Y -st41,-,,,,fep- 15 Foot 18 Foot 3"diameter 98500315 98500318 4" diameter 98500415 98500418 x 5"diameter 98500515 98500518 5.5"diameter 985005515 985005518 6" diameter 98500615.. 98500618 7"diameter 98500715 98500718 CD 8"diameter 98500815 98500818 @11 ` New Ultra Light thickness(.005")available. 20 Foot 25 Foot 141* Add"UL"to Part Number. Ex.98500315UL 3"diameter 98500320 98500325 4" diameter 98500420 98500425 Custom Ovalizing#98990001 5"diameter 98500520 98500525 5.5"diameter 985005520 985005525 6"diameter 98500620 98500625 7"diameter 98500720 98500725 8"diameter 98500820 98500825 30 Foot 35 Foot 3"diameter 98500330 98500335 4"diameter 98500430 98500435 5"diameter 98500530 98500535 5.5"diameter 985005530 985005535 6"diameter 98500630 98500635 7"diameter 98500730 98500735 8" diameter 98500830 98500835 Kit includes:SS Flexible Liner,Termination Cap,16"x16"Top Plate,Universal Connector ■s■■ Standard pallet quantity is 6 but some sizes may vary.Call for exact amounts. ' .� Stainless Steel Flex 5 Kit(Type 316L) 7 ` Size Order# , x 6"x 5' 98530605BS z" �, 8"x 5' 98530805BS i f. ' Kit Includes:Ovalized Flex Liner,Insulation Blanket,Universal Connector,Bottom Damper 4 Note:Bottom Damper Sealing Kits 40 800 729 9505 651 460 6080 fax sales@dalsinmfg.com www.dalsinmfg.com • Light Si Flex Liner DALSIN LINE Stainless Steel Two-Piece Flex Tee Kit(Type 316L) {Zj � Size Order# Order# 15 Foot 18 Foot 3"diameter 98510315 98510318 7-. 4"diameter 98510415 98510418 __, 5"diameter 98510515 98510518 �+ 5.5"diameter 985105515 985105518 6"diameter 98510615 98510618 - 7"diameter 98510715 98510718 8"diameter 98510815 98510818 20 Foot 25 Foot X New Ultra Light thickness(.005")available. Add"UL"to Part Number. 3"diameter 98510320 98510325 Ex.98500315UL 4"diameter 98510420 98510425 Custom Ovalizing#98990001 5"diameter 98510520 98510525 5.5"diameter 985105520 985105525 6"diameter 98510620 98510625 7"diameter 98510720 98510725 8"diameter 98510820 98510825 30 Foot 35 Foot 3"diameter 98510330 98510335 4"diameter 98510430 98510435 5"diameter 98510530 98510535 5.5"diameter 985105530 985105535 6"diameter 98510630 98510635 7"diameter 98510730 98510735 8"diameter 98510830 98510835 Kit includes:SS Flexible Liner,Termination Cap,16"x16"Top Plate,Two-Piece Flex Tee,Flex Tee Cap t. Standard pallet quantity is 6 but some sizes may vary.Call for exact amounts. mad Stainless Steel Flex Pellet Kit(Type 316L) 25 Foot 35 Foot Size Order# Order# 3"diameter 98520325 98520335 jF 4"diameter 98520425 98520435 { 4"/3" diameter* 98524325 98524335 "4"/3"Kit sold with 4"liner and 4"tee main with 3"take off. :PT Standard pallet quantity is 6 but some sizes may vary.Call for exact amounts. sr r -f- tosi New Ultra Light thickness(.005")available. Add"UL"to Part Number. Ex.98500315UL 800 729 9505 651 460 6080 fax sales@dalsinmfg.com www.dalsinmfg.com 41 Light SS Flex Liner DALSIN�LINE Light Round Flexible Stainless Steel Liner(Type 316L) 1° -r i, 25 Foot Len fli, gth 35 Foot Length Per Foot(50'Max) Dia. Order# Order# Order# 3" 98010325 98010335 98010301 sy. 4" 98010425 98010435 98010401 CD 5" 98010525 98010535 98010501 5.5" 980105525 980105535 980105501 Iti(kr- New Ultra Light thickness(.005")available. 6" 98010625 98010635 98010601 Add"Ur to Part Number. 7" 98010725 Ex.98500315U1 98010735 98010701 8" 98010825 98010835 98010801 Custom Ovalizing#98990001 9" 98010925 98010935 98010901 10" 98011025 98011035 98011001 12" 98011225 98011235 98011201 ■:■■ Standard pallet quantity is 6 but some sizes may vary.Call for exact amounts. Hinge Cap(Type 316L) 9 16"x 16" Support Plate 18"x 18" Support Plate a § it Diameter Cap Size Order# Order# Pry' '413" 9"x 9" 98624003 — 4,';,4':;:, it ,i-,,,,2-w: 4" 9"x 9" 98624004 — 5" 9"x 9" 98624005 — 5.5" 9"x 9" 98624055 — 6" 9"x 9" 98624006 — 7" 13"x 13" — 98624007 8" 13"x 13" — 98624008 Note:Available with support plate frame.Call for price. 24 Gauge Flex Rain Cap (Type 316L) a a A i4 With Mesh Without Mesh Diameter Order# Order# _ `ayp 3" 98621003 98620003 >. 4" 98621004 98620004 5" 98621005 98620005 ;-" 5.5" 986210055 986200055 6" 98621006 98620006 7" 98621007 98620007 8" 98621008 98620008 9" 98621009 98620009 10" 98621010 98620010 12" 98621012 98620012 Note:This item is available with or without mesh. 42 800 729 9505 651 460 6080 fax sales@dalsinmfg.com www.dalsinmfg.com Light SS Flex Liner DALSIN LINE 24 Gauge Low Profile Flex Rain Cap(Type 316L) t 1, Size Order# e- *' 3" 98623003 4" 98623004 e 5" 98623005 ��t 5.5" 986230055 • 6" 98623006 �° 7" 98623007 8" 98623008 9" 98623009 10" 98623010 X 12" 98623012 24 Gauge/18 Gauge Stainless Steel Flex Support Plate Size Gauge Order# ,,, 9"x9" 24 986810** z 9"x13" 24 986812** 13"x13" 24 986814** 13"x18" 24 986817** 16"x16" 24/18 986816** 18"x18" 24/18 986819** 24"x24" 18 986824** Note:All support plates 9"and above will be made with 18 gauge. **specify two digit hole size(6"=06 10"=10) Stainless Steel Support Plate with 18 Gauge Frame Size Order# 9"x9" 98690909** 9"x13" 98690913** 13"x13" 98691313** 13"x18" 98691318** 16"x16" 98691616** 18"x18" 98691818** 24"x24" 98692424** Note:Frame will be spot welded to the support plate. **specify two digit hole size(6"=06 10"=10) 24 Gau a Pellet Tee(Type 9 yP 316L) Size Order# 3" 98540103 ` '� 4" 98540104 }' 4"/3" 985401043 " 4"/3"=4"tee main with 3"take off. 800 729 9505 651 460 6080 fax sales@dalsinmfg.com www.dalsinmfg.com 43 Light SS Flex Liner DALSIN LINE 12" -: 24 Gauge Two Piece Flex Tee (Type 316L) Size Order# 3" 98630103 `4 4" 98630104 5" 98630105 X 5.5"with 6" Branch 986301055 6" 98630106 7" 98630107 8" 98630108 ellt 9" 98630109 10" 98630110 12" 98630112 6" Tee Branch Extension(Adjustable Slip) -Type 316L Length Order# 9" 63010616E 13" 63010616516 24 Gauge Flex Tee Cap (Type 316L) :0; '_ �* Flex Tee Cap Flex Pellet Tee Cap � s r 'z Size Order# Order# 3" 98630203 98550203 4" 98630204 98550204 Flex Tee Cap ` ►.,:;_ 5" 98630205 — 5.5" 986302055 — Flex Pellet Tee Cap 6" 98630206 — 7" 98630207 — 8" 98630208 — 9" 98630209 — 10" 98630210 — 12" 98630212 — 24 Gauge Appliance Connectors(Type 316L) . Universal Connectors Insert Appliance Connectors Size Order# Order# Universal Connector 3" 98531003 98531003E 4" 98531004 98531004E 5" 98531005 98531005E Insert Appliance Connector 5.5" 985310055 985310055E 6" 98531006 985310065 Note: 7" 98531007 98531007E Universal Connectors are used to connect flex to stove or connect two pieces of flex.Insert Appliance Connectors are 8" 98531008 98531008E used to connect the liner to a fireplace insert when there is a close clearance between the insert and the lintel. 9" 98531009 98531009E 10" 98531010 985310105 12" 98531012 98531012E 44 800 729 9505 651 460 6080 fax sales@dalsinmfg.com www.dalsinmfg.com Light SS Flex Liner DALSIN LINE Stainless Steel Insert Offset Adaptor(Type 316L) 1 Large Small Shoeboxillt, -3.,,,,-=‘-''''"O' I Size Order# Order# Order# 6" 5350906 5350912156 5350916 . Large 8" 5350908 — — r-. Note:(Large Adaptor) '1 El Adjustable a full 6"from front to back;Low Profile(only 3"box height). Removable door for clean out access }l 1 1 ' Shoebox Small 24 Gauge 45°and 30' Flex Elbows (Type 316L) 141 45°Flex Elbow 30'Flex Elbow Size Order# Order# 4" 9861450416 9861300416 5" 9861450516 9861300516 6" 9861450616 9861300616 7" 9861450716 9861300716 8" 9861450816 9861300816 9" 9861450916 9861300916 10" 9861451016 9861301016 12" 9861451216 9861301216 24 Gauge 90°Flex Elbow(Type 316L) Size Order# Nt 4" 9861900416 5" 9861900516 6" 9861900616 7" 9861900716 8" 9861900816 9" 9861900916 10" 9861901016 12" 9861901216 24 Gauge Flex Reducer(Type 316L) Size Order# .14)1141‘ 4"x3" 9865040316 6"x5" 9865060516 6"x5.5" 9865065516 7"x6" 9865070616 8"x6" 9865080616 Stainless Wire Mesh—25' Rolls ,; Fits Liner Sizes Order# am 4" 7" 519007 r t ;;Yf 8"-9" 519011 . 10"-11" 519012 800 729 9505 651 460 6080 fax sales@dalsinmfg.com www.dalsinmfg.com 45 Light SS Flex Liner DALSIN LINE 2.5" Cold Weather Foil Tape Description Order# 2.5"x 50 Yard 517002 l;, X Stainless Steel Wire Description Order# f 366' 519001 Note:Sold in 1 lb.can;Each can=366' � W 3M Adhesive Glue Spray Can Kj Description Order# 16.9 oz 519002 8 Lb. Ceramic Wool Insulation Blanket Foil Faced 25' Rolls Size Fits Liner Size Order# .25"x18" 3",4" 517018 .25"x24" 5",6" 517024 .25"x30" 7",8" 517030 .25"x48" 9"and above 517048 .5"x18" 3",4" 518018 .5"x24" 5",6" 518024 .5"x30" 7",8" 518030 .5"x48" 9" and above 518048 Note:Use 0.25"blankets with 1.00"clearance to combustible;Use 0.50"blankets with zero clearance to combustible. - Insulation Blanket Kits Size Order 3",4"Liner Size,.25"x18"x25'Insulation Blanket 517018025KT 5",6"Liner Size,.25"x24"x25'Insulation Blanket 517024025KT 7",8"Liner Size,.25"x30"x25'Insulation Blanket 517030025KT 3",4"Liner Size,.5"x18"x25'Insulation Blanket 518018025KT 5",6"Liner Size,.5"x24"x25'Insulation Blanket 518024025KT 7",8"Liner Size,.5"x30"x25'Insulation Blanket 518030025KT Kit includes:Insulated blanket,wire mesh,foil tape and 3M adhesive spray Hose Clamps Description Order# 2.5"to 4.5" 9800064 4.5"to 6.5 9800096 5.75"to 7.75" 9800116 6.5"to 8.5" 9800128 9.75"to 10.75" 9800164 11"to 12" 9800200 1.75"to 16" 9800248 46 800 729 9505 651 460 6080 fax sales@dalsinmfg.com www.dalsinmfg.com