35-004 (4) 88 TURKEY HILL RD BP-2021-1007
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:35 -004 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: Wood Stove BUILDING PERMIT
Permit# BP-2021-1007
Project# JS-2021-001722
Est.Cost:
Fee: $40.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: THE FIRE PLACE 99401
Lot Size(sq.ft.): 39988.08 Owner: RILEY JOHN D
Zoning: Applicant: THE FIRE PLACE
AT: 88 TURKEY HILL RD
Applicant Address: Phone: Insurance:
P 0 BOX 606 (413) 397-3463 () WC
WHATE LYMA01093 ISSUED ON:3/16/2021 0:00:00
TO PERFORM THE FOLLOWING WORK:WOOD INSERT
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: Oil: Insulation:
Final: Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTO UP N VIOLATION OF
ANY OF ITS RULES AND REGULATIONS. I
h
Certificate of Occupancy signatnre.1 Y u
FeeType: Date Paid: Amount:
Building 3/16/2021 0:00:00 $40.00
212 Main Street, Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
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City of Northam �
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,, DEPARTMENT OF BUILDING INSPECTIONS 7 '
,,, 212 Main Street • Municipal Dui 'ng S t3 a
�� '` Northampton, MA 01060' )T,co, CQ(7, / �3s i V,INC'
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APPLICATION FOR SOLID FUEL APPLIANCE IN TAtLATION
Property Information
Owners Name: ,�/Ir/ /"/e
Address: ,f 7 /v�/ y F // (r) , A/tor/A4.rxpfon
(No.) (Street Address)
Phone: Ste .5 C -G�72 Cell: Email:
Owners Si ^
�ature: 4./ wt:( y Date: / ///2/
Contractor's Information (If Applicable)
Name: %)do?/13 Z 'M7h,ec Phone: 11 3 7,7 .F V4 -3
Construction Supervisor's License #: 92 S/-0l Expiration: /-6--W
Home Impr. Contractor License #: /ffcV 77 Expiration: //-AP-aa
Stove Information /n(5fa//IP? 411 rcff-/max 5-S 7/nci^ i,do 90vc
Type of Fuel (check all that apply): Wood Y Pellet Coal
Location: tr5P flocr Freestanding Insert
Manufacturer:`/),,_ t/ i c• L/rryY Model: "%S Q101cr/r-..
FOR BUILDING DEPARTMENT USE ONLY---------..--____-_--___-_-
Permit# til "oZ('07 Date Wed: Total all Fees: $�# ID 4* I.2 '7/
Building Official: i
�� /� •15-26 Z
B zng Office 1 �v 5 Date Issued: J� /
Signature of Building Official: 17r_
The Commonwealth of Massachusetts
• Department of Industrial Accidents
7 \r,t Office of Investigations
. s' Lafayette City Center
4% 2 Avenue de Lafayette, Boston,MA 02111-1750
\£ ,, ,
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: General Businesses
Applicant Information Please Print Legibly
Business/Organization Name:THE FIRE PLACE
Address: 100 STATE ROAD
City/State/Zip:WHATELY, MA 01093 Phone#:413-397-3463
Are you an employer?Check the appropriate box: Business Type(required):
I. I am a employer with 10 employees (full and/ 5. ❑ Retail
or part-time).* 6. ❑ Restaurant/Bar/Eating Establishment
2.❑ I am a sole proprietor or partnership and have no 7. ❑ Office and/or Sales(incl.real estate, auto,etc.)
employees working for me in any capacity.
[No workers' comp. insurance required] 8. Non-profit
3.❑ We are a corporation and its officers have exercised 9. ❑ Entertainment
their right of exemption per c. 152, §1(4),and we have 10.0 Manufacturing
no employees. [No workers' comp. insurance required]**
4.ElWe are a non-profit organization, staffed by volunteers, 11.0 Health Care
with no employees. [No workers' comp. insurance req.] 12.❑ Other
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
**If the corporate officers have exempted themselves,but the corporation has other employees,a workers'compensation policy is required and such an
organization should check box#I.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy information.
Insurance Company Name:MA RETAIL MERCHANTS WC GROUP INC
Insurer's Address:P.O. BOX 859222-9222
City/State/Zip: BRAINTREE, MA 02185
Policy#or Self-ins. Lic. #014005033601116 Expiration Date: 1-1-22
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under§25A of MGL 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 Investigations of
the DIA for insurance coverage verification.
I do hereby certify;
fj under the pains am enalties of perjury that the information provide above is true and correct.
Signature: e� �- Date:
Phone#: 413-397-3463
Official use only. Do not write in this area,to be completed by city or town official.
City or Town: Permit/License#
Issuing Authority(check one):
l.❑Board of Health 2.1=1 Building Department 30 City/Town Clerk 4.❑Licensing Board
5.0 Selectmen's Office 6.DOther
Contact Person: Phone#:
‘www.mass.gov/dia
Minimum Fireplace and Hearth Dimensions - Ember Protection:
Combustible flooring in front of the fireplace insert must be protected from hot embers by non-combustible
material extending;
I • Canada-18"to the firing side(From the Glass)and 8"to each side of the unit.
• U.S.A.-16"to the firing side(From the Glass)and 8"to each side of the door opening.
1 , Consult CAN/CSA-B365 Installation Code for Solid-Fuel-Burning appliances and equipment in Canada,and
N.F.P.A.211 Standard for chimneys,fireplaces,vents and Solid-Fuel-Burning appliances in USA.
26 . ► I CAN: 24 7/8"/63Omm '�
I 66Omm
I I f 22 1/2 "� I USA: 22 7/8" �1 .n.
57Omm I 'NM
NrIN
I I 21 "
535mm 18 3/s" I CANMI IN
A 465mm X 18"/4O6mm M M
16" Ember USA: 16"
—� 8„ /it-- Fireplace Hearth 4O6mm \ .
- -
200mm Protection
t , ;•
- Masonry• Hearth
Figure 3: Fireplace opening dim.-ALT5 Insert LE.
Hearth Requirements: Figure 4:ALT5 Insert LE-Ember protection.
The fireplace's non-combustible masonry hearth must extend 16"in front and 8"beyond each side of the
existing fireplace opening.See Figure 3.
Optional Leveling Legs
Leveling legs(bolts)are provided if you need them to level or steady the insert on an uneven hearth.
• If you fireplace is lower than the hearth mount the rear leveling leg bolts. Prop the unit up to access
threaded inserts under the sides towards the rear of the unit.Thread supplied bolts into inserts,set depth
to correspond to depth of fireplace drop.
• If your hearth is lower than the fireplace floor install the front leveling bolts. Prop the unit up to access the
threaded inserts under the front,towards the sides of the unit. Thread the supplied bolts into inserts.
•
Push the Insert into position in the fireplace and adjust the leveling bolts as needed to level the Insert.
PACT FIC
mry��.
ENERGYGy 100003038 12 ALT5 LE Insert 230819-32 ALT5 LE Insert 230819-32 13 100003038 Iy
Clearances Dimensions
The minimum required clearances to surrounding combustible materials when installed into a masonry or «�==»�R��,�
factory built fireplace are listed below and in Figure 5. I -�
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.,
# ,..._ . . --
v_ __,=,
A 21,/2' 1
' �� 545mm 20 7/8"
' r ,ii.:. 530mm
Mantel or Top Facing I B 17^
_ _ I' 430mm
_ ��� 1080mm ,ova `_
265mm
15 .2I �— 251/4"
I 130mm c
— LL 645mm
o = I�— 22 t/s"
III Surround Heights
��_ _ r!) 560mm
""""" _- t t Dimension Standard Oversized
••' 6" 17 7/8' 1 81/4' 30 3/8' 341/8'
10» / 155mm 455mm I \ 210mm A
�J 770mm 865mm
254mm
II — _ 13 am" 9 5/8' 8 29 3/9 33 1/8
Pd 30't PI _�� �• -I 'T4�— 245mm 745mm 865mm
1 • T, . ,3 -_:1 1* r L
/ Fireplace hearth \
t .-J:17
0 The Insert is equipped with a 6"I.D.
33 s/a^_� Rue Collar.
Figure 5: Clearances-ALT 5 Insert LE. 855mm
Minimum Clearances to Combustibles:
Figure 2:ALT 5 Insert LE Dimensions.
Side of Blower Cover to Adjacent Sidewall 10 in.(245 mm.)
Side of Blower Cover to Side Facing(max 3-1/2 in.deep) 6 in.(155 mm.)
Top of Cast top to Mantel Facing 12 in.(305 mm.)
Top of Cast Top to Mantel(max 12in.deep) 12 in.(305 mm.)
CAUTION:Unit hot while in operation.Parts of the appliance,especially the external surfaces,
will be hot to touch when in operation.Keep children,clothing and furniture away.
Contact may cause skin burns.
PACIFIC - PACIFIC
ENERGY 100003038 14 ALT5 LE Insert 230619-32 ALT5 LE Insert 230819-32 11 10000303S ENERGY