29-224 (7) 136 ACREBROOK DR BP-2019-1215
GIS#: COMMONWEALTH OF MASSACHUSETTS
MamBlock:29-224 CITY OF NORTHAMPTON
Lot• 01 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL 042A)
Categom woodstove BUILDING PERMIT
Permax BP-2019-1215
Project# JS-2019-001968
Est.Cost:$2589.00
Foe:S40 OQ PERMISSIONIS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use croup: Homeowner as Contractor_
Lot Siu(sc.R.): 14897.52 Owner: HERNDON AUDREY&CHRISTOPHER
Zoning, Applicant: HERNDON AUDREY & CHRISTOPHER
AT: 136 ACREBROOK DR
Applicant Address: Phone: Insurance:
136 ACREBROOK DR
FLORENCEMA01062 ISSUED ON:4/3012019 0:00:00
TO PERFORM THE FOLL0WING WORKNERMO NT CAST I N GS WOOD STOVE
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector
Underground: Service: Meter:
Footings:
Rough: Rough: House# Foundation:
Driveway Final:
Final: Final:
Rough Frame:
Gas: Fire Department Fireplace/Chimney:
Rough: QJ! Insulation:
Final: Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occuoancv Signature:
FeeTvpe: Date Paid: Amount:
Building 4/30/20190:00:00 $40.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
City of Northampton
d hcCEIVEDBeBChaaatte F
DSPAR'Zim'N}' OF aUILDZaO ZSBPECTZOnS i c
212 Mein Street • aunicipal building J fca`
— ApR 3 C 7019 I No havpton, M 01060
'i , O /
SINGLE OR TWO FAMILY SOLID FUEL APPLIANCE PERMIT APPLICATION , (,7\
FOR WOOD,COAL, PELLET,CORN,STRAW OR SIMILAR STOVES,OR FIREPLACES
Check# q/ '
Please fill in all appropriate information
1. Name of Applicant: Audrey Herndon
Address: 136Acrebrock Drive, Florence,MA01062 Telephone: 860-986-3904
2. Owner of Property
Address: Telephone:
3. Status of Applicant: %/ Owner Contractor
4. Type or Brand of Stove : Vermont Castings Intrepid It Catalytic Wood Stove
5. UL Listing : ANSIUL-1482-2011 and ANSUUL-737(see specsheet)
6. Estimated Cost: $500(stove);$2589.38(installation)
7. Email . audhemdOgmail.com
If applicant Is not the homeowner::
Contractor name Email
Construction Supervisor's License Number Expiration Date
Home Improvement Contractor Registration Number Expiration Date
All Applicants must complete a Workers Compensation Insurance Affidavit before we can issue a permit
8. Certification: I hearby certify that the information contained herein is true and accurate to the best of my
knowledge.
DATE: 4127/2019 APPLICANT'S SIGNATURE
DATE: HOMEOWNER'S SIGNATURE
APPROVED 2
DATE: q-30-2M BUILDING OFFICIAL
f
PRODUCT SPECIFICATIONS (VIW INTREPID II CATALYTIC WOOD STOVE _1tinNu
21 h
(545 mm)
24"
(610 mm) 2514"
(640 mm)
"* Top exit
flue collar
12 height
p i+$t Rx iY=e` 7W
.•,"K ' (160 mm
ACTUAL DIMENSIONS _
Unit Depth:21 " (6 (546 mm)(flue collar in top exit position) I � 45 m �1
Unit Height:24" (610 mm) (545 mm) _
Unit Width: 21 1/2" (546 mm)
TECHNICAL INFORMATION
Log Length: up to 16" (406 mm) 21rh"
Burn Time: up to 5 hours r 1Vi"
Heating Capacity: up to 1,200 sq.ft.(112 m2) (545 mm) (31 mm)
Maximum Heat Output 36,000 BTUs/hr, 18" _
Efficiency Rating: 85% (460 mm)
EPA Emissions Rating:2.1 grams/hr
Weight: 22316s.(101 kg)
Flue Collar:6" round, reversible 'tn•mu
Firebox Volume: 1.3 cubic foot(.04 m')
Clearances(with optional heat shields)
Back: 16" (406 mm)(measured to back of stove top) 201,^
Corner: 12" (305 mm) (520 mm)
Side.24"(610 mm)
FIELD INSTALLED ACCESSORIES
•Spark screen for open door fire viewing
•Available in Classic Black, Biscuit,Majolica Brown, Ebony
Black and Bordeaux
• Matching enamel pipe in four standard colors
•Clearance reducing rear heat shield
• Handy warming shelves with mitten racksL-- 134" —�
•Outside air adaptor (350mm)
•Stove surface thermometer
• Height-reducing short legs-3 1/8"(79 mm)
A Brand of Monessen Hearth Systems Co.
149 Cleveland Drive, Paris, Kentucky 40361
www.vermontcastings.com
SEEB KFORMOREINFOR 10N
r
PRODUCT SPECIFICATIONS VF Oti T
INTREPID II CATALYTIC WOOD STOVE
(CONTINUED).. . .
STOVE CLEARANCES
UNPROTECTED SURFACE PROTECTED SURFACE
CORNER CORNER
PARALLEL INSTALLATION INSTALLATION PARALLEL INSTALLATION INSTALLATION
Side(A) Rear(B) Corner(C) Side(D) Rear(E) Comer(F)
No heat shields 24" 30" 20" 12" 16" 10"
(610 mm) (762 mm) (508 mm) (305 mm) (406 mm) (254 mm)
Top exit, rear heat 24" 16" 12" 12" 9" 10"
shield,single will (610 mm) (406 mm) (305 mm) (305 mm) (229 mm) (254 mm)
pipe w/connector
shields2
Rear exit, rear heat 24" 14" WA 12" 9" WA
shield only' (610 mm) (356 mm) (305 mm) (229 mm)
Top exit, rear heat 24" 16" 12" WA WA WA
shield, double wall (610 mm) (406 mm) (305 mm)
pipe°
+i +A
.►, a �o �e e
I ' f: �►B nIF � E�
Stove installed Stove installed Stove installed Stove installed
parallel to wall corner parallel to wall corner
'Shielding for a top exit stove must include the stove rear heat shield insert to protect the area behind the flue collar.
2Chimney connector heat shields, in an installation that goes through a combustible ceiling, must extend to 1" (25 mm)below the ceiling
heat shield,which is 22" (559 mm)in diameter.The ceiling heat shield should be 24 gauge or heavier sheet metal,centered on the chimney
connector,and mounted on noncombustible spacers.
'Rear exit-horizontal from the flue collar directly back through the wall.
In top exit installations,this clearance requires the use of the rear heat shield with the shield insert installed.
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The Commonwealth of Massachusetts
Department of Industrial Accidents
I Congress Street,Suite 100
Boston,MA 02114-2017
www.mass.gov/dia
IFRockers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers.
TO BE FILED WITH THE PERMITTING AUTHORITY.
Applicant Information /� Please Print Leeibly
Name(Business/OrganizatioWindividuap: A" ADUA�- //
Address: �3(o AGE4ZC,C-00Ic- DV--
City/State/Zip: Phone#: R�,O ^ QK - 3q d+
Are you an employer?Check me appropriate box: Type of project(required):
1.❑I mna cmpinycr with empluye<s(Ponmer.,pen-Wne1• 7. ❑NeW construction
2.❑l am a role proprietor or partnership and have no employees workers formeln S. E] Remodeling
any capanty.1No wmlorni comp.Ireumnce requved.]
J.❑lamahomeowner doing allarork myself lNoworkers'comp.immvrarcamc ired.l' 9. El Demolition
a T.�l I�m a hmfar and will be hiring conmcunce to emeduct all work m my pmpmy. I will ID❑Building addition
`N rc mat all<oneacmrs eiNu na.e workers'wmpensation nuuurance or are sole I1.❑Electrical repairs or additions
proprietors wit no employcea 12.❑Plumbing repairs or additions
51 am a several emboolorend I have bored me sub-conmetom ham
rad on me ched shoot. 13.❑Roof repairs
❑Them sub-contractors have employees and have workers'comp.imurance 1
6.❑We are a emporium and its officers have exacined their right Of exemption per MGL a 14.�OthE[w�c 1� STDV�
152.4,1(4).and we have no employees.[No workers'comp.insurance required.]
'Any applicant that checks Mx#I meal atm PII out the...Isloo:showing their workers'compensation policy information.
I Homeownms who submit this affidavit indicating may art doing all work and men hire outside connectors must submit a new affidavit indicating such.
:Conmetors tat check til box must amched an edditios d sbor showtg the name of tc subconmctma and nate whaler or not tbeat enriries have
employ. If the mc-ocandreas have employee;they must provide their workerscomppolicy number.
I am an employer that is providing workers'compensation insurancefar my employees. Below is the policy and job site
information.
Insurance Company Name:
Policy#or Self-ins.Lic.#: Expiration Date:
Job Site Address: City/State/Zip:
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under MGL c. 152,025A is a criminal violation punishable by a fine up to$1,500.00
and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a
day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance
coverage verification.
I do hereby eeylifjl;pI'dt e pains an permli sof perjury that the information provided above is nue and correct.
SimnDate:
Ph # U '1
Official use only. Do not write in this area,to be completed by city or town official.
City or Town: Permit/License#
Issuing Authority(circle one):
1. Board of Health 2.Building Department 3,City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6. Other
Contact Person: Phone#: