37-022 15 '-4" /
N
Di- Parting Single Panel
Exterior Pocket Doors
CV
�t-
verhead Beam
0
t G.
FISHMAN RESIDENCE
IAMII V QrVnnn DcninW /A
I
11 -5/8 _ _9-3/4 22-3/8 -.. _
1 ■ 1
1 1
! 1 7/8
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I
co
1 Lo
N
l0. 1
‘zr N
_9 -3/4 _ 9-3/4 `'
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24
I
61 -1/2
I
1
1
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SOVEREIGN FRONT& SIDE ELEVATIONS
BUILDERS LLC SCALE 1/2 " =1' PG 3 OF 3
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0 Specifications Exclaim -42
Please consult the manufacturer's
HEAT G l..O installation manual for all details and Exclaim 42
No one builds a better fire requirements before making a final Wood burning Fireplace
design layout decision.
MODEL FRONT WIDTH BACK WIDTH HEIGHT DEPTH FIREBOX OPENING
Actual Framing Actual Framing Actual Framing Actual Framing
EXCLAIM -42 42 x 28 -1/2
50 -1/2 51 -1/2 34 -1/2 51 -1/2 49 -5/8 SO 27 -1/2 28 -1/2
I. 34 -1/2" ,.
[876]
21u lit ' 9-1/2"
2 �=11 [241]
[699] lir
I L1. nn1
50-1/2" �1
[ ]
Top View
59 -1/4" 55 -1/2"
[1505] [1410]
49 -5/8" ■ "'�rl r III effective height
u■ ,r•:w`i ui
[1260] ■ ■n;r 2 1/2"
tr■ - ,.�ri ■ r■i [7-24]
n■Ail%;nrsal 49-1/8" Imo pm ma ...1 r. ■i ■n [1248]
- y ' -
7 -5/8" 42" [1067]
[
Front View
; -
Outside '
Air 1 i
Knockout I ! Knockout
I 9 -1/4" I:,
.. :.1 [235] I
8 -5/8 .. „ ' 5/8
[219 -_' i5- -- a 219]
9 -5/8" 9 -1/2" 118 -1/2"
[244] [241] — '1 [470]
Left Side View Right Side View
Additional information can be found online at www.heatnglo.com or www.fireplaces.com
APPLIANCE LOCATION FRAMING DIMENSIONS
---s5 sre' (1667) --1 = i � 2 Can a i r space min. �`
z1 - tr2 W 8724] air space
[ 5Y 1309 1 c leararxz3 from
chimney �.
5 &17[15111 w 240j' \ � '
�� > 1�
/ /// Si Man exterior I
Irk 123561 into a garage Fireplace heade can not be
Aaoss a posdi until after Firep
4 6-- V� °pn1ef assembly (s in place -
�` 2 (724j H oned MUST NOT be
« 2i4:) _ ' notched.
9 - 112' 8" [t6] and [1511( 081 --1' mnfi0araams
2-1 m 1111111 48• 0 50"
(119 5 n. 2' 7241 [1270]" MOT 1 910,
24" Asa 51 - 112" 1"
[61 ' � .. ,— [ 1308 ) t
8 Extra space required
[7241' for outside air
MANTEL PROJECTIONS " If interior of chase will be drywalled, add thickness connection
to this measurement.
i " Adjust header height for raised floor under unit
Combustible Wall Combustible 7 ft [2134]
Decorative Facing minimum base of fireplace CLEARANCE TO COMBUSTIBLES
to ceiling
2 x 4 stud wail Storm Collar Ill
x_xn j
12' (305 --.t Roof Flashing
Stan • � �1 12" [3051
- •asent
2' [1] mini mum repre air space
PiPe. ICE required around
minimum t
Non
Decorative - • 6' [152] (attic) Attic
such as: ste rrrirrrrrlum trrsrilation
brick, tile, •. - y Shield
i -1l2' [381 insulatio
slate, glass, •, - 1 maximum 4 U l i l l i ti.' Witt
Seal joint with Measured from top of ''i : :
non - combustible fireplace opening AM'
sealant All OlfsefdRetum (secured
2' [51] min. 4-0 with hanger straps)
� ; (ceiling)
Ceiling Firestop Must have 2' [51] minimum
�= clearance to header
MANTEL LEG /WALL PROJECTIONS
I Adapter attached here (not shown)
:x: r t:
Grid represents o• to level of
1" scale standoffs
FLUSH 1 3! ' BRICK 4 " '
m
a
FRONT - FR* NT [102] �\.� Back asdesaunR
L— MI m : 1 - 12' [381 (except at nail
; :r_ � w 3 48' flanges where it
a
22 318' 0 42" [1067] —. [121s] t
VT 113]
56 �` r, 19 -3/4" 0 0 to floor
[ ] ,...., a 50 -112" [1283] 44 [ 2] "
so , iii
HEARTH EXTENSION CONSTRUCTION
24" 24"
[610] [610] Continuous,
non - combustible
sealant
Tile, stone or other
HEARTH EXTENSIONS non - combustible
HX4 Hearth Ext material m Protective
or equivalent insulation. ti Metal Hearth
Fro-M2.-_w._ _ See install manual / I 2" [51) - 1.-
r ■ l: >':: Floor constructed of
required
lit ::::::0110L-,-,,,,, he:" wood or other combustible
�2 material
Via:
Product information provided is not
PRODUCT LISTING CODES complete and is subject to change
US UL 127 without notice. Product installation
66" [1676] �y 20" must adhere strictly to instructions
/� 12[508] accompanying product to avoid risk
�'/ [305] CAN ULC - S610 of fire and potential injury.
Additional information can be found online at www.heatnglo.com
H E AT6 G L O, A brand of Hearth & Home Technologies Inc.
No one builds a better fire Lakeville, MN Phone: (800) 927 - 6841 CON UEf91l
Web: www.heatnglo.com
ws/HNG/EXCLAIM42_0512
,
The Commonwealth of Massachusetts
Department of Industrial Accidents Print Form
cl, . l '4 Office of Investigations
1 Congress Street, Suite 100
Boston, MA 02114 -2017
` www.mass.gov /dia
Workers' Compensation Insurance Affidavit: Builders/ Contractors /Electricians /Plumbers
Applicant Information Please Print Legibly
Name ( Business /Organization/Individual): r ' "T
Address: / 3 S ...5,0,,_,F4 r. f i 12,r.1
City /State /Zip: W ,0 104 ,4 ,4.. Phone #: H/ 3 -- 7- ?oo /
Are you an employer? Check the appropriate box:
Type of project (required):
1. C1 I am a employer with 4. El I am a general contractor and I
employees (full and /or part-time).* have hired the sub contractors 6. 0 New construction
2.0 I am a sole proprietor or partner- listed on the attached sheet. 7. IgRemodeling
ship and have no employees These sub - contractors have g, ❑ Demolition
working for me in any capacity. employees and have workers'
[No workers' comp. insurance comp. insurance.' 9. Building addition
required.] 5. u We are a corporation and its 10.0 Electrical repairs or additions
3.0 I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs
insurance required.] t c. 152, §1(4), and we have no
employees. [No workers' 13.0 Other
comp. insurance required.]
*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.
'Contractors that check this box must attached an additional sheet showing the name of the sub - contractors and state whether or not those entities have
employees. If the sub - contractors 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 Name: C f a .f � cf , S t W 41 r C°
Policy # or Self -ins. Lic. #: k _ , Expiration Date: / 6. 2O/5
1
Job Site Address: 2. 6 "i i ln t L 4 tire / /AI A / City /State /Zip: (-�i,-„Kar �, SS
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 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 c raft under the p ins and pen' ties of perjury that the informal ion pi pi!oilided above is Prue and copped - .
Kr Date: /D7.2 6��1 2—
Signature: �
Phone #: y/ ; " 2 - ! — roc
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 #:
SECTION 8 - CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor:
C / Not Applicaable ❑
L
Name of License Holder : T a C efi two, / 60/76
License Number
-S' SotAilitmpt60 Rc i t i f t 4 4 % oV, M A ► . 9 ' / I 4 . 9 1 3
Address Expiration Date l
1 113 X2.7Zoao
Signature lephone
9. Registered Home Improvement Contractor: Not Applicable ❑
15 g L 1 O
Company Name % Registration Number
QVa 8 Go dela 9,013
Address J� 'y Expiration Date
1 �.+ �crw►' '� q/ bm P Telephone 40 6J /
SECTION 10- WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.G.L. c. 152, § 25C(6))
Workers 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 Yes El No ❑
11. - Home Owner Exemption
The current exemption for "homeowners" was extended to include Owner - occupied Dwellings of one (1) or two(2) families
and to allow such homeowner to engage an individual for hire who does not possess a license, provided that the owner acts
as supervisor. CMR 780, Sixth Edition Section 108.3.5.1.
Definition of Homeowner: Person (s) who own 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 shall not be considered a homeowner.
Such "homeowner" shall submit to the Building Official, on a form acceptable to the Building Official, that he /she shall be
responsible for all such work performed under the building permit.
As acting Construction Supervisor your presence on the job site will be required from time to time, during and upon
completion of the work for which this permit is issued.
Also be advised that with reference to Chapter 152 (Workers' Compensation) and Chapter 153 (Liability of Employers to
Employees for injuries not resulting in Death) of the Massachusetts General Laws Annotated, you may be liable for person(s)
you hire to perform work for you under this permit.
The undersigned "homeowner" certifies and assumes responsibility for compliance with the State Building Code, City of
Northampton Ordinances, State and Local Zoning Laws and State of Massachusetts General Laws Annotated.
Homeowner Signature
SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable)
IT E o n n
New House Addition Replacement Windows Alteration(s) Roofing
0 ❑ Or Doors p C11 . O O
Accessory Bldg. Demolition New Signs [ ] Decks [ ] Siding [ ] Other [ ]
Brief Descri ion of Pr l 1
Work: , osed
Ww ,,I m `P a + I WJ 'i�`11 E ' 1 i- arvtaw. 6t, r c v 6
- -wo o Y.'$ ' 4. /LS e it IJ(c, l 1o' d ° 1 i, 6.4,, e, V'o *Y».
Alteration o existing bedroom Yes No v Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes . No
Plans Attached Roll - Sheet
6a. If New house and or addition to existing housing, complete the following:
a. Use of building : One Family Two Family Other
b. Number of rooms in each family unit: Number of Bathrooms
c. Is there a garage attached?
d. Proposed Square footage of new construction. Dimensions
e. Number of stories?
f. Method of heating? Fireplaces or Woodstoves Number of each
g. Energy Conservation Compliance. Masscheck Energy Compliance form attached?
h. Type of construction
i. Is construction within 100 ft. of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No
j. Depth of basement or cellar floor below finished grade
k. Will building conform to the Building and Zoning regulations? Yes No .
I. Septic Tank City Sewer Private well City water Supply
SECTION 7a - OWNER AUTHORIZATION - TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, P6 7 1i" -- t -- LI a.V1 , as Owner of the subject
property —�'
hereby authorize . ° i ck Gi CM- i! (.t trO■
to act on my behalf, in all matters relative to work authorized by this building permit application.
:.■ .. . r...
--., ,� �,�.� /0 6 1
Signature of , A Date
1, [, die 6.c.- A- ( L UAi''L. , as Owner /Authorized
Agent hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge
and belief.
Signed under the pains and penalties of perjury.
T ( CJ
Print Name
IgIl
10 J 1
Sig - � ner /Agent Date
'+ F ,
e
Section 4. ZONING AU Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information
Existing Proposed Required by Zoning
This column to be filled in by
f2,ri)iina ilrnartrnrni
Lot Size
Frontage
Setbacks Front
Side L• R: L: R:
Rear
Building Height
Bldg. Square Footage
Open Space Footage
(Lot area minus bldg & paved
parking)
# of Parking Spaces
Fill:
(volume & Location) i l
A. Has a Special Permit /Variance /Finding ever been issued for /on the site?
NO Q DON'T KNOW Q YES Q
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO Q DON'T KNOW Q YES Q
IF YES: enter Book Page and /or Document #
B. Does the site contain a brook, body of water or wetlands? NO Q DON'T KNOW Q YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Q Obtained Q , Date Issued:
C. Do any signs exist on the property? YES NO
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property ? YES NO
IF YES, describe size, type and location: Q Q
E. Will the construction activity disturb (clearing, grading, axcavatinn, nr filling) nvnr 1 arre nr is it part of a common plan
that will disturb over 1 acre? YES NO
IF YES, then a Northampton Storm 3er ManagemeCermit from the DPW is required.
€ \ Department use only
Cit of Northampton
Status of Permit
••, . 2012 Bui • ing Department Curb Cut/Driveway Permit
2 2 Main Street Sewer /Septic Availability
cslotis "00M 100 Stater/Well Availability
pS • • pton, MA 01060 Two Sets of Structural Plans
N oRT"A p one 413 - 587 -1240 Fax 413 - 587 -1272 Plot/Site Plans
Other Specify
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 - SITE INFORMATION
1.1 Property Address: This section to be completed by office
p ‘ o Q t+1v1`t �1 L ur j Map Lot Unit
Zone Overlay District
Elm St. District CB District
SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT
2.1 Owner of Record: .5Afrn WI / (�/�
�Q, 04 1�!' ^C G I °tAtlf &ivi L 4 wS/ Pettii
Name (Print) r' '�t� Current Mailing Address:
Y ./ ` t 1_t-._ _ Telephone
Signature
2.2 Authorized Agent:
Name (Print) Current Mailing Address:
Signature Telephone
SECTION 3 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollars) to be Official Use Only
completed by permit applicant \
1. Building r}/ O o 1(a) Building Permit Fee
j
2. Electrical 0 (b) Estimated Total Cost of 0
Construction from (6)(�
3. Plumbing 0 Building Permit Fee
4. Mechanical (HVAC) .,-51.5 ,,,-
5. Fire Protection
6. Total = (1 + 2 + 3 + 4 + 5) Check Number //S
\ \\ This Section For Official Use Only /
Date Building Permit Numb Issued:
/7 7
Signature:
/7//
Building Commissioner /Inspector of Buildings Date
26 MT LAUREL PATH - 600 FLORENCE RD BP-2013-0517
GIS #: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 37 - 022 CITY OF NORTHAMPTON
Lot: -000 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: renovation BUILDING PERMIT
Permit # BP- 2013 -0517
Project # JS- 2013- 000828
Est. Cost: $4500.00
Fee: $55.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: SOVEREIGN BUILDERS INC.
Lot Size(sq. ft.): Owner: FISHMAN PETER
Zoning: Applicant: SOVEREIGN BUILDERS INC
AT: 26 MT LAUREL PATH - 600 FLORENCE RD
Applicant Address: Phone: Insurance:
135 SOUTHAMPTON RD (413) 527 -8001 Workers
Compensation
WESTHAMPTONMA01027 ISSUED ON:11/2/2012 0:00:00
TO PERFORM THE FOLLOWING WORK:INSTALL FIREPLACE, REMOVE 2 WALLS &
INSTALL BEAM
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 NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupancy Signature:
FeeType: Date Paid: Amount:
Building 11/2/2012 0:00:00 $55.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Louis Hasbrouck — Building Commissioner