29-034 Adams Stove Company
- 108 '/2 Columbia Street
Adams, Ma 01220
Phone - 413-743-2775
Fax - 413-743-0189
YO
The St. Croix pellet stove/furnace, model f y, Mserk and serial number
has been pre-tested and certified by Adams Stove Company to verify full working order
of all moving and electrical parts. The Adams Stove Company has also fully inspected
the appliance to ensure that the stove/furnace was free of any flaws, dents, scratches, or
breakage. This document verifies that the new owner in which is picking up or having
the St. Croix pellet stove/furnace delivered from the Adams Stove Company agrees that
the appliance was indeed in full working and operating condition, and free of any
blemishes when it left the store. The Adams Stove Company is not responsible for
damage or customer negligence after the appliance is out of our possession. The Adams
Stove Company is also not obligated to answer any service, installation, or technical
information after time of purchase. All sales are final after the time of purchase. By
signing this document, you the customer understand and agree fully to the above terms.
Date: � `�' j �_ 1 5� 11
Adams Stove Co.
Date:
Customer
w
t
THE EXHAUST TERMINATION LOCATION MUST BE AT LEAST: (FIGURE 10)
1' (305 mm) ABOVE the ground level
7' (2.1 m) FROM a public walkway
1'(305 mm) FROM The wall penetration point
.3 (915mm} FROM a gas meter!reguiator assembly
2' (610 mm) FROM any adjacent combustibles such as:
Adjacent buildings, fences,protruding parts
of the structure, roof eaves or overhangs,
plants, shrubs, etc-
Note. Certain local code restrictions ;nay apply. Check with Local Officials first before
installing.
t�
CLEARANCE TO WALL
PENETRATION POINT
CLEARANCE TO PUBLIC WALKWAY
LlCLEARANCETO COMBUSTIBLES
24'
.711
f
i
12"
17,
PUBLIC WALKWAY
CLEARANCE TO GROUND
FIGURE 10
VENTING: TERMINATION CLEARANCE REQUIREMENTS SIDE VIEW
(All dimensions shove MINIMUM distances)
Prescott Series Installation?Manual
Page 14
i
VENTING: TERMINATION REQUIREMENTS
In determining optimum vent termination, carefully evaluate external conditions especially when
venting directly through a wall. Since you must deal with odors. gases, and fly ash, consider
aesthetics, prevailing winds, distances from air inlets and combustibles, location of adjacent
structures and any code requirements.
L Exhaust must terminate above combustion air inlet elevation.
2. Do not terminate vent in any enclosed or semi-enclosed area, (Le_ Carports, garage, attic
crawl space, etc.)which can build up a concentration of fumes_
3. Vent surfaces can get hot enough'to cause burns if touched by children. Non-combustibly:
shielding or guards may be required.
The clearance under a veranda, porch, deck or balcony must be a minimum of 24" as long as the
veranda, porch, deck or balcony is fully open on 2 sides beneath the floor
mumuff
TaItINNAL
- - - - - - --- - - - - -
. . . . . . . . . . . .
- - - - - - - - - - -
. . . . . . . . . . . . . . ..
. . . . . . . . . . . . . . . .
-- - - - - - - - - - - J"Tex"NA
- - - - - - - - - - -
. . . . . . . . . . .
. . . . . . . . . . .
. - - - - - a - - - -,
. . . . . . . . . . .
0
Figure 9. Venting: Termination requirements
Plain View
(All dimensions show Minimum distances.)
4' (1.2 m) BELOW a door,window,cavity, or air vent
4' (1.2 m) HORIZONFIALLY FROM a door.window, cavity, or air vent
1' (305 mm) ABOVE, a door. window,cavity,or air vent
Note; These dimensions do not apply to a window that cannot be opened or that has been fixed in
a closed position.
Prescott Series Installation'vfanual
Page 13
M
FLOOR PROTECTION
Hearth models may be placed directly on the noncombustible hearth of a fireplace.
Floor protection is required for the area directly under the stove and extending 6" beyond the
front of the stove as shown.
oil {
t
1
699
i
i
L
Figure 12
Floor protection (Top View)
Hastings Installation manual
Page 17
•
MINIMUM CLEARANCES(INCHES)TO COMBUSTIBLE MATERIAL
Figure(s): From:
14, 16B Sides of stove 4"
14, 16A, B Back of stove 4"
13 Corner of stove 4"
13 Vent pipe 3"
15 Stove to mantel 12"
15 Floor protection: Front (from faceplate) 6"
t 12 Floor protection: Sides & back of stove 0"
16A Alcove: Vertical to Combustibles 16"
16B Alcove: Sides 4"
16A. 16B Alcove: Back 4"
1
1 41'REQIARED TO ACCESS CONTROL,BOARD �--- ------
ON THE REAR RIGHT SIDE OF STOVE 4 _ 4"
_t
till
^'Fm
4" \✓r� f%
4"
Figure 13 (Top View) Figure 14. (Top View)
Clearances: corners of stove Clearances Sides and Back
Hastings Installation manual
Page 18
Venting size Guidelines
Type of Installation: . Size:
A. Less than 10' horizontal: 3" Acceptable
B. 10' to 12' horizontal: 3"or 4" Acceptable
C. Over 12' horizontal: 4" Required
(A horizontal installation over 12' is NOT RECOMMENDED)
D. Less than 15''vertical: 3" Acceptable
E. Over 15' vertical: 4" Required
V Above 4000' elevation: 3"or 4" Acceptable
Note:Four(4) inch vent may be used in aU installations. If in doubt, use 4"vent.
A
-- 24.75"
--„'•�--- 23.75" ---i
t !
111 I`
ttS j� • • i �1l
8 £ O O O i (• t f
!,
35.125.1
i
C
� 1
t F
} 13.3'7{.. (I � I250"
D E
750" 850"
Figure 1. REAR VIEW
A- Width of stove D - Side of stove to center of intake tube
B - Height of stove E- Side of stove to center of exhaust
C -Center of intake tube from floor F -- Center of exhaust from floor
V
Preu:ott Series Installation Manual
Page 7
GENERAL INFORMATION
SAFETY PRECAUTIONS
SAVE THIS
INSTALLATION MANUAL
f
i
i
s,4FETY NOTICE: The .stove must he properly installed in order to prevent the possibility of a
house fire' These installation instructions must he .strictly observed! Failure to rnllux
e instructions mat result in property damage. hoddv injury or even death.
y The stove's exhaust system works with negative combustion chamber pressure and a slightly
positive chimney pressure. Therefore, it is imperative that the air intake and exhaust system be
l airtight and installed correctly. Do not install a flue damper in the exhaust vent of this unit.
f
Do not connect this unit to a chimney Slue serving another appliance or to any air distribution
duct or system.
BUILDING PERMIT
Contact the local building officials to obtain a permit and information on any local installation
restrictions and inspection requirements,
. DEFINITION OF"STOVE
The word "stove' as used in this manual is interpreted to mean a pellet burning freestanding
stove, insert. or zero-clearance fireplace, unless otherwise noted.
SAFETY TESTINC
The stove has been independently tested and listed by Warnock Hersey Laboratories in
accordance with the proposed A STM Standards and the applicable portions of UL 1482 and
ULC S6271B366.2, and Oregon Administrative Rules 814-23-901 through 814-23- 909, stating
f. requirements for installation as a, stove, heater or hearth insert for masonry, metal and zero
clearance fireplaces and for mobile home installations_ The safety-listing label is located on the
back of the stove.
DISCLAIMER OF WARRANTY
Since Even Temp Company has no control over the installation of stove, Even Temp Company
grants no warranty, implied or started, for the installation of a stove and assumes no responsibility
for any special, incidental or consequential damages_
�t
pre cots Seriea Installation Manual
Page I
I a
8/30/2006 WEb 13:59 ' FAX 402 728 5379 EVEN TEMP
Q00
the snot reliable!
August 30,2006
Adarns Stove Company
108 'A Columbia Street
Adams, NfcX 01220
Phone: (413) 743 2775
Fax: (413) 743_0189
Dave Meier
This letter is to confirm to you 171-1c Vent Appliance design of the St. Croix pellet &
corn stove models listed bclow.-
The models Afton llal-, J?rescott L-:.Xp, Prescott E 1, Hastings, Greenfield, .Auburn,
1-2nc-,z-,t--r & SC-F-050 furnace are c<,,1.,;(ructCd :1, -X
wadi Di
1(3ns have been met:
Appli2nCe if the following
store to an (AILSidesotirce (>f coj-nbu�
fanual i as described in the Installations
m the tons
';ectloll c0"'c`;19('0171hustion All-
A Suove with this tvpe of MISNI)Afioll then draw all <)f the appliance's
fturn the outside ;ltmospberc- s combustoll 1117
' flue
x-entin Yst '-�L � "ns'se-S are rented to the outside atrnospl)cre through
g�%V -cm of choice, i'l-lat Uncets, the specifications listed in the Installations manual-
Fary Krumrei
St CW13, Product Development pvIallagex
POL Box 127 1jkh&wy34• ST. CROIX. A PRO13""T OF I-VE,V TEMP, jjqt�C--
ftw.8e6nmAa6&60*T011 Free Voice:(8w)33,,%W2-ftm(402)728-5Z5-7MAw,-,zx 0503W-8367
780 CMR. STATE BOARD OF BUILDING REGULATIONS AND STANDARDS
ONE AND TWO FAMILY DWELLINGS-CHIMNEYS,FIREPLACES AND
SOLID FUEL-FIRED APPLIANCES
hazard for flammable vapors, dust, combustible requirements and the requirements of 780 CMR
fibers or other highly combustible substances). 36.
Exception:solid fuel-feed appliances listed for Exception:Solid fuel-burning appliances listed
such locations. for exhaust vent termination other than through
a chimney.
3610.6.4 Air for combustion and ventilation:
Solid fuel-bu�appliances shall be installed in a 3610.65.1 Chimney connector clearance to
location and manner to assure satisfactory combustibles:See 780 CMR Table 3610.6.5.1.
combustion of fuel, proper chimney draft and
maintenance of safe operating temperatures. 3610 65.2 Chimney But size: For solid fuel-
Combustion air may be obtained from interior burning comfort heating appliances for one--and
spaces when the interior space containing the two handy use, the cross-sectional area of the
appliance bas a volume,in cubic feet equal to one:- flue shall not be less than the cross-sectional
twentieth (1/20) of the output Btu rating of all area of the appliance flue collar. The cross-
fuel-lxuning appliances in the space. When sectional area of the flue shall not be more than
buildings are so tight as to preclude adequate three times the cross-sectional area of the flue
infiltration,provisions shall be made to introduce collar of the appliance,
outside air for combustion and ventilation.
3610.6.5 Chimney connection: All solid fuel-
burning appliances shall be connected to chiocaneeys
in accordance with their listing,the manufacturer's
Table 3610..65.11'2
CHIMNEY AND/OR VENT CONNECTOR CLEARANCES TO
COMBUSTIBLE MATERIALS/SOLID FUEL-BURNING APPLIANCES ONLY
Minimum Minimum
Clearance Clearance
Description of Appliance Connector T in mm
Residential-Type Appliances Single-wall Metal Pipe 18 457
Connector
Residential-Type Appliances Type L Vent Piping 9 229
Connector
Law-hear Appliances Single wall Metal Pipe 18 457
Boilers, Furnaces,Water Heaters Connector
Medium-Heat Appliances Single-wall Metal Pipe 36 914
Connector
High-Heat Appliances Masonry or Metal Note 3 Note 3
Connector
1. For greater detail and guidance,refer to NFPA 211, Section 6-5.
2/20/98 (Effective 3/1!98) 780 CMR-Sixth Edition 6I3
780 CMR: STATE BOARD OF BUILDING REGULATIONS AND STANDARDS
THE MASSACHUSETTS STATE BUILDMG CODE
Exception: When the appliance is otherwise
listed for such connector application and the 780 3621.4 VENTS
respective requirements of 248 CMR or
527 CMR, if applicable,so allow. 3621.4.1 Type of vent required:Gas-fired and oil-
fired appliances shalt be vented in accordance with
3521.3.4.5 Clearance: Connectors shall be 248 CMR or 527 CMR as applicable. Solid fiiel-
mstaBed with clearance to combustibles as set burning applies shal be vented in accordance with
forth in NFPA 211, Section 6-5.1. Reduced the requirements of 780 CMR 3610.6.5.2 and
ckwances to combustible material shalt be in 3610.6.6 and additionally in accordance with their
accordance with NFPA 211,Section 6-5.1.2. listing and manubcturer's requirements, as
3621.3.4.6 Access: The entire length of a applicable.
connector shall be accessible for inspection, 3621.4.2 Termination: Vent termination shall
clog and replacement• comply with 780 CMR 3621.4.2.1 and 362I.4.2.6.
36213.4.7 Fireplace connection: An appliance 3621.4.2.1 Through the roof: Vents passing
skill not be connected to a chimney Sue serving a through a roof shall extend through flashing and
(replace unless the fireplace opening is sealed or terminate in accordance with the manufacturer's
the chimney flue which vents the fireplace is installation requirements.
Permanently sealed below the connection. (Also
see 780 CMR 3610.6.5.2).
input of 50,000 Btulh(14 655 W)or less shall be
3621.4.2.2 Natural draft appliances: Vents for located not less than nine inches(229 mm) from
natural draft fossr3 fuel-fired appliances Shan any opening through which vent gases could enter
terminate at heights above the highest connected a building- The vent terminal of a direct vent
appliance in accordance with the requirements of appliance having an input exceeding 50,000 Btu/h
248 CMR or 527 CMR as applicable, otherwise (14 655 W)shall be located not less than 12 inches
such vents shall terminate at least five feet (1524 (305 mm)from the opening. The bottom of a vent
mom)above the highest connected appliance outlet, terminal and an air intake shall be located at least
and natural draft gas vents serving wall furnaces I2 inches(305 mm)above grade and in all cases
shall terminate at an elevation at least 12 fi:et shall comply to manufacturer's installation
(3658 mm)above the bottom of the firnaace.Also requirements when such requirements exceed the
see 780 CMR 3610 generally. criteria of 780 CMR 3621.4.2.5.
3621.4.23 Type B or BW vent. See 248 CMR. 3621.4.2,6 Mere draft systems.
Mechanical draft systems other than direct vent
3621.4,2.4 Type L vent:For oil-feed appliances, systems shall be installed in accordance with
see 527 CMR (in the absence of guidance from 248 CMR or 527 CMR if applicable, otherwise
527 CMR,such vents shag terminate not less than such systems shall be installed in accordance with
2 fug(610 mm)above any portion ofthe building their listing and the manufacturer's installation
within ten feet(3048 mm)). requirements.
3621.4.2.5 Direct vent appliances: See 3621.43 Installation: Type B, Type BW and
248 CMR or 527 CUR if applicable, otherwise:, Type L vents shall be installed in accordance with the
the vent#terminal ofa direct vent appliance with an applicable requirements of 248 CMR or 527 CUR
544 780 CMR.-Sncth Edition 2/7197 (Effective 212&97)
Figure 5
I
Insert must be installed on Non Combustible Hearth
-- Hearth or Hearth Extension must extend 6"from Face of Insert
Minimum Fireplace Opening
Masonry and Zero-Clearance
Figure 6
1ss"
16"
24"
28"
Note: Certain brands of venting components may require more than 16" minimum
fireplace depth. 16" depth can only be attained with 3" single wall venting. May
require shortening the snout on the Single wall Tee.
York Installations Manual
Page 10
,s
Clearance to Combustibles
Masonry and Zero-Clearance
COMBUSTIBLE MANTLE
COMBUSTIBLE TOP FASCIA
" 3
C
Qw A
G y
D B
O
O U
U
Figure 4
A Top of Insert to Combustible Mantle 12"
B Side of Insert to Combustible Wall 4"
C Side of Insert to Combustible Side Fascia 6"
D Top of Insert to Combustible Top Fascia 4"
For information on Hearth requirements see Figure 5 on page 9. The York Insert must be
installed on the non-combustible hearth of the fireplace. A non-combustible surface must extend
a minimum of 6" measured from the face of the unit.
York Installations Manual
Page 9
4
I» — 22.7" +I
r-- 4.3"
C�
16"
e
0 12.65"
CAUTION: The
minimum depth of
16 inches is only Top View
attainable with a 3" Figure 2
vent system and the
use of single wall
components. May
require shortening
the snout of the
Tee.
O
0
21.25" o
!� 18.32"
Side View
Figure 3
York Installations Manual
Page 8
i
Venting size Guidelines
Type of Installation: Size:
A. Less than 10' horizontal: 3" Acceptable
B. 10' to 12' horizontal: 3" or 4" Acceptable
C. Over 12' horizontal: 4" Required
(A horizontal installation over 12' is NOT RECOMMENDED)
D. Less than 15' vertical: 3" Acceptable
E. Over 15' vertical: 4" Required
F. Above 4000' elevation: 3" or 4" Acceptable
Note: Four(4) inch vent may be used in all installations. If in doubt, use 4" vent.
York Insert Dimensions
— 45"
32"
Front View
Standard surround
Figure t
York Installations Manual
Page 7
i
GENERAL,INFORMATION
SAFETY PRECAUTIONS
SAVE THIS
INSTALLATION MANUAL
SAFETY NOTICE: The stove must be properly installed in order to prevent the possibility of a
house fire! These installation instructions must be strictly observed. Failure to follow
instructions may result in property damage, bodily injury or even death.
The stove's exhaust system works with negative combustion chamber pressure and a slightly
positive chimney pressure. Therefore, it is imperative that the air intake and exhaust system be
airtight and installed correctly. Do not install a flue damper in the exhaust vent of this unit.
Do not connect this unit to a chimney flue; serving another appliance or to any air distribution
duct or system.
BUILDING PERMIT
Contact the local building officials to obtain a permit and information on any local installation
restrictions and inspection requirements.
DEFINITION OF"STOVE"
The word "stove" as used in this manual is interpreted to mean a wood pellet burning
freestanding stove, insert, or zero-clearance fireplace unless otherwise noted.
SAFETY TESTING
The stove has been independently tested and listed by Warnock Hersey Laboratories in
accordance with the proposed ASTM Standards and the applicable portions of UL 1482 and
ULC S627/B366.2, and Oregon Administrative Rules 814-23-901 through 814-23- 909, stating
requirements for installation as a stove, heater or hearth insert for masonry, metal and zero
clearance fireplaces and for mobile home installations. The safety-listing label is located on top
of the hopper.
DISCLAIMER OF WARRANTY
Since Even Temp Company has no control over the installation of a stove, Even Temp Company
grants no warranty, implied or stated, for the installation of a stove and assumes no responsibility
for any special, incidental or consequential damages.
York Installations Manual
Page 1
i
CREOSOTE-FORMATION AND NEED FOR REMOVAL
When wood is burned slowly, it produces tar and other organic vapors, which combine with expelled moisture to form creosote. The creosote
vapors may condense on the inside of the chimney liner during slow-burning firing periods. As a result, creosote residue accumulates on the
chimney liner. When ignited, this creosote makes an extremely hot fire.
* To properly inspect the liner system it is necessary to gain access to the top and/or bottom of the chimney.To inspect the liner from the bottom
remove the connector pipe from the appliance and the chimney.Using a flash light and a mirror look in and up the liner to visually inspect for
soot and creosote formation.Note: if the chimney has offsets you may not be able to see all the way to the top or to the bottom depending on
your inspection locatipn. In this case it will be necessary to inspect the liner from both the bottom and the top of the chimney.
* After inspection,if cleaning is required,use a plastic bristle brush the same size as the interior of the liner.Either push the brush up from the
bottom or down from the top using the appropriate number of extension pole for the height of the chimney. When cleaning from the top
remove the liner cap before inserting brush in the top of the liner.
8.)OPERATION
For M-Flex liners, insulated with Premier Mix, used to vent a solid fuel burning appliance please note:
Solid fuel burning stoves can be used immediately after the installation is complete. However the flue gas temperatures entering the liner
should not exceed 500 degrees F. for a period of three weeks.A connector pipe flue gas thermometer will help monitor this procedure.
Fireplaces can also be used immediately after the installation is completed.A small to moderate fire should be maintained for a period of approxi-
mately three hours.After this time a normal fire can be established.
It is important that the operator not over fire the appliance during these initial periods.
PRODUCT INFORMATION: M-Flex 316L
M-Flex 316L Stainless Steel Flexible Chimney liner is designed ro reline existing chimneys or used as a liner in new construction.Manufactured
in the highest quality,mill certified,316L grade alloy MFlex Stainless Steel Flexible Chimney Liner has a high acid fighting capability.Listed by
UL Laboratories to UL 1777 standard for zero clearance installation.M-Flex can be used to vent wood,wood pellet,coal,non-condensing gas and
oil, making it the choice for venting all standard efficiency installations. M-Flex is available in 3" to 30" diameter to cover a wide range of
requirements found in the field today.
The unique manufacturing systems used to make M-Flex utilizes a continuous strip of stainless steel, interlocked and diagonally crimped to
produce a gas and water tight lining system of superior strength and durability. M-Flex can be bent to negotiated offsets in chimneys and can be
ovalized to custom sizes to fit most any installation.The corrugated construction allows for expan-
sion and contraction during the heat up and cool down periods,removing any stress on the system.
M-Flex can be insulated with either a Premier Mix or Thermal poured insulation or with a foil-
faced ceramic wool blanket to meet UL 1777 standards for chimney exteriors with zero clearance ' s
to combustibles.
M-Flex can be shipped UPS in the following lengths Y-50',4"-44', 5"-38', 6"-32', 7"-26', 8"-20'.
All other diameters and lengths exceeding those above must be shipped road freight.
M-Flex Stainless Steel Flexible Chimney Liner carries a Life Time Warrantee for all fuels, with
appliance efficiencies at 83 percent or lower.
PRODUCT INFORMATION: M-FLEX 294C SS LINER
M-Flex 294C Stainless Steel Flexible Chimney Liner is designed to reline existing chimneys or
used as a liner in new construction.Manufactured in the highest arade mill certified AL294C alloy
M-Flex 294C has the greatest acid fighting ability to combat the acidic condensate produced by ru!4 +�Ik9 ,.
todays high efficiency boilers. Listed by Underwriters Laboratories M-flex 294C can be used to
rt the•�iwfr� �� �
vent gas fired appliances with AFUE'S of 83%or greater. M-Flex 294C is available in diameters of Fisx,itner
3" to 24" to cover the wide range of appliance requirements found in the field today. a+asu
L LbOd ,
remier i+l+� �,
The unique manufacturing system used to make M-Flex 294C utilizes a continuous strip of stain wkh an r •
a a l Lifspd +y ',�
less steel, interlocked and diagonally crimped to produce a gas and water ti„ht lining system of remlerNdi �odr '�
superior strength and durability. M-Flex 294C is extremely flexible and can negotiate offsets in her.tpq,,yy'
SUti�O�nulra'r ��il}�
chimneys with ease. It can also be ovalized to custom configurations to fit most any installation. .etae Yzn ,Fry%
The corrugated construction allows for expansion and contraction with in the liner removing any cdairq '
stress on the liner system. '� •,
For best performance of the appliance and the venting system M-Flex 294C can be insulated with
either Premier Mix poured insulation or Premier Wrap ceramic wool blanket. Insulation should
always be used on exterior chimneys.
M-Flex 294C carries a Life Time Warrantee for all installation venting condensing gas appliances.
Flex 294C can be shipped UPS in the following lengths: Y-50', 4"-44', 5"-38', 6"-32', 7"-26' 8"-
20'. All other diameters and lengths exceeding these above must be shipped road freight.
chimney. Put thabase plate up through the damper opening and around the bottom of the liner.Secure the base plate to the liner with stainless
steel rivets,stainless steel screws,or a support clamp below the base plate.Once base plate is secured pull liner up and seat base plate on top
of smoke chamber. At this point hold liner in place by pushing 2x4 tee up through damper and across bottom of liner. Install top hardware at
top of chimney as described in previous section.
* To install the base plate through the face of the fireplace will, require more work and masonry skill. Start by removing two to four bricks in
either the face or the back of the fireplace at the level of the top of the smoke chamber. If the smoke chamber is constructed correctly there
should be approx.eight inches of masonry to g.o through. Once this opening has been accomplished slide the base plate into the hole over the
top of smoke chamber Slide the liner down from the top of the chimney and through the hole in the base plate. Secure with stainless steel
rivets, stainless steel screws,or place a support clamp.on the liner above the base plate.This will keep the liner from sliding down through
the base plate until the top hardware has been installed.Once this is complete install top hardware as described in previous section.Seal hole
in masonry with like material.
6.) INSULATING M-FLEX STAINLESS STEEL CHIMNEY LINER
A note about insulating stainless steel chimney liners: Not all situations require insulation of the chimney liner. The UL1777 Standard for
installing stainless steel chimney liners require insulation because the non-code conforming chimney has zero clearance to combustibles or some
other defect. Thus the UL1777 Standard is in place for fire protection.The definition of a code Conforming chimney is one that meets or exceeds
N.F.P.A.2I I for construction of chimneys, ie: proper clearances to combustibles, intact 5/8 fireclay flue liner or equivalent, minimum four inch
(nominal)solid chimney wall. if the chimney meets the requirement for code conforming the only reason to reline would be for appliance perfor-
mance. in case of relining for high efficiency gas or oil fired appliances(over 83%)no insulation may be required. However regardless of existing
chimney. insulating the chimney liner will improve the performance of the appliance that is connected to it. Because the insulated liner will stay
warmer the flue will not cool as quickly and will not condense as rapidly. In wood burning appliances this will reduce the amount of creosote that
will form in the liner. In oil and gas burning applications the likelihood of condensation,especially on start up of the appliance will greatly reduce.
While fire protection is the main concern, insulating liners even if not required will pay dividends by increasing performance and efficiency.
Please Note: For the installed liner system to meet UL standards, all UL listed components used must be installed with proper clearances.
THERE ARE TWO METHODS OF INSULATING M-FLEX STAINLESS STEEL LINERS
Method#1 - Insulating with Premier Mix
• Premier Mix is poured into the chimney around the liner after the liner is installed. Premier Mix is premixed and water is added to the mix
at the job site.To determine the amount of Premier Mix needed to insulate a specific liner please call National Chimney Supply,Inc..
• No minimum thickness of Premier Mix around a liner installed in a code-conforming chimney is required.The required clearance
between the liner and the interior of the masonry chimney is I" inches. In a non-code conforming chimney, ie: zero clearance to
combustibles,no flue liner,etc. the minimum recommended thickness of Premier Mix is One inch.The required clearance between the
insulation and the interior wall of the masonry chimney is 0" inches.
• Premier Mix is mixed with two to three gallons of water in a mortar pan or wheelbarrow. When mixed correctly the Premier Mix will have
a grainy consistency and little or no water will come out when squeezed in your hand. Once mixed the Premier Mix is poured into the
chimney around the liner.The liner should be vibrated during,the pouring process to help the Premier Mix settle around the liner.Continue
to pour Premier Mix until the chimney is full to the top. Install top hardware as described in previous section.
• A Premier Mix insulated M-Flex liner can be used after the installation is complete. Curing of the mix will occur over approximately 28
days, with approximately 70% of the curing process occurring in the first week. Drying time of the Premier Mix will depend on the
thickness of the mix and the absorption of the masonry chimney. Drying time will be accelerated by using the heating appliance.
Method#2-Insulating with Premier Wrap
Premier Wrap is installed around the liner before it is installed in the chimney.
e Premier Wrap is one half inch thick and one quarter inch thick,eight pound density,ceramic wool blanket with a three mil aluminum foil
face.Aluminum tape,retractable wire mesh,and mesh clamps will be needed to complete the installation. Premier Wrap is available in four
widths, 24" to fit liners 4" to 6" diameters, 30" to fit 7" to 8" diameters, 36" to fit 9" to 10" diameters, and 48" to fit I I" to 14" diameters.
* in a code-conforming chimney no Premier Wrap insulation is required. in a code-conforming chirnney that must have the tiles removed a
single one quarter inch Premier Wrap is required.In a non-code conforming chimney a single one-half inch Premier Wrap is required. The
required clearance between the insulation and the interior of the masonry chimney is 0" inches.
* To install Premier Wrap onto the liner,lay the blanket open Nvith the foil side down.Curt blanket length wise so that it will overlap approx.one
inch. Place liner on blanket and wrap around liner. Run foil tape the complete length of the seam on the blanket, next cut pieces of foil tape
approx. eight inches long, and tape across seam about every foot. Next place liner into retractable mesh sock. Using mesh clamp, clamp at
end of liner just above tee body. Pull retractable mesh sock to top of liner,continue to pull until mesh sock has retracted tightly around the
liner,clamp mesh at top and cut off excess mesh. Install liner as described in previous section.
7.)INSPECTION AND MAINTENANCE INSTRUCTIONS
Should you have any questions concerning inspection and maintenance of the M-Flex liner
Please contact:
National Chimney Supply,Inc.
Corporate Headquarters
280 Commerce St.
Williston,VT 05495
(800)897-8481
* Inspection of the M-Flex liner should be done at minimum,once per year,at no more than 12 month intervals from date of installation.If the
liner is used to vent a solid fuel burning appliance inspections should he done at intervals of every 2 months during the heating season.Upon
inspection,if soot or creosote accumulations have reached a 1/4" or more the liner should be cleaned.This inspection and cleaning should he
carried out by a nationally certified chimney sweep, or other qualified chimney professionals.
t
1
3.)DETERMINE IF„THE CORRECT SIZE LINER WILL FIT INTO THE CHIMNEY
The M-F.lex Stainless Steel Chimney Liner can be installed with in the existing flue the or the flue tile can be removed. It is extremely
important that the correct size liner will fit into the chimney.Certain factors, such as chimney construction and offsets in the chimney,may
change the size of the interior of the chimney. It is best to prove the interior of the chimney before trying to install the chimney liner.
This can be done by lowering a short piece of the intended size liner down the chimney to see if it will pass all the way to the bottom.You can
also use a liner guide cone to accomplish this. If the chimney liner will need to be insulated this will effect the required dimensions needed
to install the liner.If the round configurations needed to vent the appliance will not fit the liner may be formed to an oval configuration to fit,
however ovalizin(l the liner will change the cross sectional area. Please call National Chimney Supply,Inc.with any questions.
4.) INSTALLING M, -FLEX STAINLESS STEEL CHIMNEY LINER
* Make sure the thimbles to be used in the installation are in the proper chimney to maintain the required clearance to combustibles for the
connector pipe from the appliance. If the clearances are not correct reconstruct the thimble to the proper position.
* Determine the length of the liner by measuring from the bottom most thimble to the top of the chimney.To this measurement add approx.Six
inches to accommodate the crown and top hardware. Cut liner to length.
Remove the snout from the two part tee and attach the tee body to liner with either stainless steel pop rivets,or stainless steel screws. If the
liner is going to be insulated with a
ceramic wool blanket,install the
blanket now. If a tee cap is going to he FIGI KY:t LS t ta•I„ y. rrrr „,...... ,rNrt.:t,,,r,.r«-rr rrr,,•rr: r,r�,ryubIk'« ttr,rkrrr.waen tial beating,n:,hances.
used attach it to the body now. system �;rimmi
Take the tee snout that was removed from rnnmur.01 b..r.,u,:bnrt h Minimum 3Z In.(4J mm)rel.dries ryulnry wall tratWd,ntn r ca
h i,l•.v'•'1.•.'.:1 1:'.:r'.l>t'�n nl lrn!>Uyb1t1«v:Mlt'wln a minlmuri ri11Y-In.(,jry,-nmY bflCk
the tee body and extend the draw band r FFwi.rllml Fuur clwy lYwl >I:'n1'l«'.la,w„ F'rtl;tay Li,y (k IN1
'd..J"....n:.n.rti,q,, C91G.b-LVxAiN�,C�O]NiCn fN-Ll4y Fux Linirr('yw wimv„Iwal.
completely, slide the tee snout into the j I:In ins mm) mvinum-L-In IIG-mm}wall thl%N 105:,:hbll run from OUtCr
1 ar uai•. ,«,rr„.•-.�I I,,..:k a 111-).hv1 wt 1J7yCrV.the nMCr wrI at
thimble with the draw band centered in T ylrrnNy tlaa IVA,wnd.h.11 t,.hrody in 014
the flue. Lower the liner down from the ^Y
top of the chimney,and feed the tee body ”'w
through the draw band on the tee snout. �;""'� Mw„•:.r'i,l'wv
In rm nn. nnnr.lrnaf:;
You may have to rotate the liner to align Nr F21'
ue*rm"n,:rlrnr,Mr'nu:,mr.;n E °.'hllia,.uLrlwl,li..rrlf«cony.lxrTl,hunntryltl,u hofUltlsame Itrti28
the hole in the tee body with the snout. r"nhK.rt«i".."g..pnn^ InSIOCdlarrIa,thcchlmlwticonnpetnrAIM I4 n(,t
."i (26 a mm)cr MOM al Mutation with a mlMmum 3 M.Q-3 mm)
Once you have aligned the tee tighten the M1,,•^,m '{{ «I«nJ,««nlllewttl•wan of Itie Lrurnney enpth ano
Mtn err �Or'Y'N%"IQA.
draw band to secure the snout to the tee v I he inner end at the crdmncy lcnpth 911011 ha%inn'Mlh tea
s'otl,*e,e rnas6^ry 6MmnOy thin aro chat)ae:ealcd to the
F,wwy h•.,'' n,`tnrY,rv.. I io'rl'r fl"a and U,IhA hd,k n,.id y pN"«e.6'.I..t r".y..ntnrti.nlunllt
body. I"ril, • , ter. n:traetorr cemcm.5upwrt shat be:ecureq'roxmnan 1w,..tl
* Seal the area around the tee snout with + nY nOrhl t, ^ �jrr1^ „v i rm.�rt'
4'I ""� engm mall
mortar to form an airtight seal. °°p' ncl pcncuntc tr'c rdninay lLi4.
_ I,rw rnlmr^Y
* At the top of the chminey there are?
Options to seal and support the liner: —r n.,y+ kn
Option 1 is to install a top kit.This is
nrlw: l vl,wlJUwl wv:crt,
accomplished by first removing the rain th, „i..luwr- C 'r,e„I Ct«tllcnrmri"y:annn�br minimum 24aauac100,24In. U152
r,,^MM ^'nnn.'..m` fr.it'Im)� 1Ln:kr'„„„,hdll 0.1w)It nk.ly.rrunn,um
cap portion of the kit by loosening the "'wore+":_'Lsl 9�wge['o2+In(oat rnmpe,thickno",ha.d%a.o+
q.4..uu .,'.i'«„�'„1._nyyslM:J I„pn r.,umijunblee Oy a .
top worm drive clamp a few turns. Next, ,,,.1,-r.nrw„ winMumof0In.f l5;mrc,lof�I4Pj;Vbarinaldat,rn.(x'nrny
Y„cI l m.¢-.a env chal bo covored,antl mlmble:upporxa ww a shoot stcci
install the plate assembly over the liner, ,--.QU,
k^•„ rr n'.r„'rr'.q;l"e tQ Q2•I in.)0.61 mm)t M tlncAnora.
A �upp nwa'r«Iy r”""'Io”wNM„''An';, vr,,.0 tighten the worm drive screw until snug, n dccar4.ha�bcazcammbndhdarnlmnovjwll-A.Farranw,:; vita rJsecu re chimney-•action shall not panda-:atHmncy
then attach the plate to the masonry with
silicone or to p cons. Cut the liner flush
n,r r;on;o oa
with the top of the assembly and rein-
nn'rvtr'.aim M ',IY'I:rn':lu'IU wy vl•:,i.k�l
stall the rain cap portion of the top kit.
n nr.„'..,M'n
nl w.sn
Option 2 is to install a top plate,top sup- 'el,ln.rnM 1y;,n,rn,:;. o S4Iln.;n.,,I.Iwl.l:..Ir„':1"r,•tn'i1.1„"�r.'yF.rvll' it, ."'toe mat
W x'+Y:.L.I,wc-+br Olamecr 2In.i5t nim)larger Mon VU'.cnlmlwy rannwhlo(Ned
port clamp, and storm collar. Place the n n;mc"elu« a,.,,•„�,n ,.v,,,r, h.rnrg 1 t'26 mm)or more ot+ncuiallon.cervVp a,a pat
so-,.RIm 1 InnmyhR,r.;."w31N.4 d,„M.1„«I'dvrnr,ry 7n"tl(:tcx Or
hole in the top plate around the liner and _ °t' + �,, ,,,,,, minlmu m 24 gauge ro 024 l n.(0.6h nimjl tnlal na a.w,1hN
center the liner and top plate on top of + ,1,cr'<nn mimmum2-In.iGl-mm)air=ace xtwecn the atterlwall of
L'IVr�lr'vy a+InMY I„1M -,I ii”.y ter« ^,«ri1 i;l:ntUVGt't>Iwp.
.n,.pr MYdntum WIr(l[h n(Ch'mrwy M„P.f an„1 wll ter 17 vr.(:plb rend
the chimney,secure to chimney top with 1 ntmnco section aoncerctie wfln and:pacM t in.-25.4 ml»)
nmry born co",wAvr uy rnenna at meet dteet cu art 01aMc
masonry screws, silicone or mortar. At- „rn,,, r'r.tarha'i,tanlMl",Ny.w'3F,, n w.'.r'. „I'„n Perm. ftA
ar'd thimney:cctlor'suppoltpd nn�atn r'l'Ut,,rca y.!'”,,;1„„1
tach the support clamp around liner and ,ytKm�in.lmun 24paupe10.024•n.;a.c,mrnithlcknc:
im enwr*yhastenedWwallauraesonall.
atr ape:« ,l cnm,*,I„,mn slria4ana shall l`i r earl l:'rI aril h,kl 19'irnrwy,wcl:.r..F„.1«'.w.
secure. Place a bead of silicone itrOUnd y,Ml,l u.cdto:C01lrcohirr l wclon.hall not o-nctrucenlmnav
M1lu'rx l'%•:''r'yly oll:•:''JL:'I uVy.:'l'. till«M,yr
top of storm collar to seal. Install rain �•:' rr
cap on top of liner and secure. MJditimai rwaulroment'
t InAV141i”, ».Iarlyd uz.al;..la«I ,l, 1!I'„ .th .'III q I„Ir'OWN 1'«vr,.y I:vl"btI Iroltl matenai aM tNti havo a IhOrMM wndWI-Aty'of
To facilitate inspection and cleaning,wall 1.0 Btu-In.:hr-fl'-'r 64.38 kA-CQVhr-m'c)nr JQi A.
All :«„rw I';wy.r'd Ih.,cn.aGB«n tlns rnlmmvmw;Larger clearancoc andthlcY.noczec shall be permitted.
penetrations shall not be placed directly a nr,y�material u.cd to iox up an opcmgtor,ho ff")unwy nkp tor'ur
behind the heating appliance. n a<,."„'«r.'>r r,I«">Vw"y rr„rnr,tl.•.oxwM rvr t y)Vem u,shall p"rd m ono ccntintout piece IhrOJgh the-m.A pa:.through.yntnm and ma
c'11') y n.'ll to Ro,Nm«I 1—.of Il'N Ou„hrI»',i.e vnl Iwyoud
5.) INSTALLING M-FLEX STAINLESS
STEEL LINER FOR A FIREPLACE
* When installing a liner for a fireplace
application no tee is used on the bottom of the liner. Instead a base plate is used to seal the liner at the top of the smoke chamber. The base
plate can be installed by working up through the damper opening or by removing bricks in the face of the fireplace at the level of the top of the
smoke chamber.
* installing the base plate from the damper opening is accomplished by sliding the liner down into the smoke chamber from the top of the
4
i
National Chimney Supply, Inc.#MH25531
-�280 Commerce Street 2147C Fletcher Ave. 2601 Emory Road Bldg.#4 4219 Howard Ave.
Williston,VT 05495 Indianapolis,IN 46203 Finksburg,MD 20895 Kensington,MD 20895
INSTALLATION INSTRUCTIONS FOR M-FLEX MODEL CB &AL STAINLESS STEEL CHIMNEY LINERS
M-Flex Stainless Steel Chimney Liner are manufactured by National Chimney Supply, Inc. This lining systems is designed and listed to be
installed with in masonry chimneys used to vent the products of combustion produced by heating appliances that burn oil,gas, or solid fuels.
This liner should be installed by a nationally certified chimney sweep or other qualified chimney professional.
Each installation must be planned for the best performance of the appliance being installed. Refer to appliance manufacturer's instructions to
determine any special venting requirements for specific appliance.
The installer must contact the local building and fire code officials to determine any installation and inspection requirements. Building permits
may be required before installation. M-Flex CB and AL liner must be installed with in the local building codes. Please remember, regardless of
national codes,the local building inspectors have ultimate jurisdiction.
Do not use any materials or components other than specified in these installation instructions.
MATERIALS NEEDED TO INSTALL M-FLEX STAIT-(LESS STEEL LINER:
316L A1294C
316 Two piece or one piece tee AL Two piece or one piece tee
Tee Cap Tee Cap
90 Deg.or 45 Deg elbow: 90 Deg or 45 Deg elbow
Coupler Coupler
304 Top plate 304 Top plate
Top Support Clamp or Top Kit Top Support Clamp or Top Kit
Storm Collar Storm Collar
Liner Rain Cap I Liner Rain Cap
INSULATION MATERIALS (if applicable)
Part# Description
PVY4 Premier Wrap 1/4" Foil Faced Ceramic Wool Blanket
PW2 Premier Wrap 1/2" Foil Faced Ceramic Wool Blanket
PM Premier Mesh Protective Wire Mesh Sleeve
Foil Aluminum Foil Tape
FA1540(large/small) Mesh Clamp
PRMIX Premier Mix
1.)INSPECTION AND PREPARATION OF CHIMNEY
The existing chimney must meet the following codes for proper construction and compliance requirements before the liner can be installed:
• The chimney must be a minimum of ten feet high,and a maximum of one hundred feet in height.
• The chimney must have the proper wall thickness, ie: minimum of 4 inches(nominal) solid masonry units.
• The chimney must extend at least three feet above the highest point where it penetrates the roof structure.and at least two feet higher than any
portion of the building or adjoining structures with in ten feet.
• If the chimney is constructed inside the structure a minimum of two inches of unobstructed air space must surround the chimney to any
combustible material. If the chimney is constructed on the outside of the structure, one inch of unobstructed air space must be maintained
between the chimney and all other combustible materials.
• When the chimney passes through an floor,ceiling,or other horizontal or vertical structure,fire stops of a non-combustible material must be used
**IFTHE PROPER CLEARANCES LISTED ABOVE CANNOT BE DETERMINED THE LINER MUST BE INSTALLED WiTH A ULLISTED CHIMNEY INSULATION,*
• Do not connect any appliance that burns a liquid fuel to a chimney liner used to vent a solid fuel burning appliance.
• The connector pipe used to connect the appliance to the chimney liner must meet proper clearances to combustibles as determined by the
appliance manufacturer's installation instructions, the national building code, or the local building code, which ever is in force.
• Before the liner is installed the chimney must be cleaned thoroughly to remove all deposits of soot,creosote,or glazed creosote.A proper
inspection must be done to determine that the chimney is structurally sound. If the structural integrity of the chimney is found to be in
question, ie: missing, loose, or cracked masonry or mortar joints. repairs must be made before installation of the chimney liner.
2.)SIZING THE PROPER LINER DIAMETER
• For solid fuel burning appliances the cross sectional area of the linear shall not be less than the cross sectional area of the appliance outlet
collar.The cross sectional area of the flue shall not be more than three times the cross sectional area of the appliance outlet collar. For solid
fuel burning fireplaces the liner should be at least one-tenth the square inches of the square inches of the fireplace opening.Please note that
this formula can vary based on height of the chimney and other determining factors.Call National Chimney Supply,Inc.should
you have any questions.
• For liner sizing of gas and oil burning appliances please refer to N.F.P.A 54 for gas and N.F.P.A31 for oil..Also refer to appliance manufacturer's
instructions. Incorrectly sized liners for these appliances can lead to performance problems and condensation with in the lining
system.Please call National Chimney Supply,Inc.should you have any questions.
t
el_
NOTICE z W NOTICE
TO u
TO
o
EMPLOYEES a �` EMPLOYEES
The Commonwealth of Massachusetts
DEPARTMENT OF INDUSTRIAL ACCIDENTS
600 Washington Street,, Boston, Massachusetts 02111
617-727-4900 — http:://www.mass.gov/dia
As required by Massachusetts General Law, Chapter 152, Sections 21, 22&30, this will give you notice that
I (we) have provided for payment to our injured employees under the above mentioned chapter by
insuring with:
ZURICH-AMERICAN INSURANCE GROUP
NAME OF INSURANCE COMPANY
P.O. BOX 1450
MIDDLEBORO MA 02344-1450
ADDRESS OF INSURANCE COMPANY
(GZZUB-0221M35-0-08) 07-04-08 TO 07-04-09
POLICY NUMBER EFFECTIVE DATES
BARDWELL BOWLBY & KARAM 87 EAST ST
PO BOX 1700
PITTSFIELD MA 01201
NAME OF INSURANCE AGENT ADDRESS PHONE-f#
MEIER, DAVID DBA MEIER 108 1/2 COLUMBIA STREET
ENTERPRISES
ADAMS
MA 01220
— EMPLOYER ADDRESS
EMPLOYER'S WORKERS COMPENSATION OFFICER(IF ANY) DATE
MEDICAL. TREATMENT
The above named Insurer is required in cases of personal injuries arising out of and in the course of
employment to furnish adequate and reasonable hospital and medical services in accordance with the
provisions of the Workers' Compensation Act. A copy of the First Report of Injury must be given to the
injured employee. The employee may select his or her own physician. The reasonable cost of the services
provided by the treating physician will be paid by the insurer, if the treatment is necessary and reasonably
connected to the work related injury. In cases requiring hospital attention, employees are hereby notilicd
that the insurer has arranged liar such attention at the
NAME OF HOSPITAL ADDRESS
TO BE POSTED BY EMPLOYER
ac ? W20PIG02
s
Board of Building Regulations and Standards
HOME IMPROVEMENT CONTRACTOR
Registration: 159784
Expiration: 5/27/2010 Tr# 269002
Type: Individual
DAVID S.MEIER
DAVID MEIER
108 1/2 COLUMBIA STREET
ADAMS,MA 01220 Administrator
>ria..achu.cctt. Dcpalintcnt of Public SafctN
Bt>arrd of Buildnm, Rc--,ukttion% and Standards
Construction Supervisor License
License_ CS 54937
Restricted to: 00
DAVID S MEIER
108 1/2 COLUMBIA ST
ADAMS, .MA 01220
Expiration: 4/12/2010
Tru: 27825
Restricted to: 00
00- unrestricted
1G-1 2 Family Hoare$
Failure to possess a current edition of the
Massachusetts State Building Code
is cause for revocation of this license.
Refer to: www.Mass.Gov/DPS
t
e
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
tit,
600 Washington Street
Boston, MA 02111
%;.`.1-0'
ltrlatTlY,tftaSS gOV/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information (� Please Print Legibly
Name (Business7Organizatiot y'Indn-idual):
Address: �� 'l� C�1�M
City/State/Zip: A4NU (� "> Phone#: 9 17�� j
Are yo an employer?Check the appropriate box; Type of project(required):
1. I am a employer with ❑ I am a general contractor and i
employees(full and/or part-time).* have hired the sub-contractors f' ❑ New construction
2.Q I am a sole proprietor or partner- listed on the attached sheet. 7. Q Remodeling
ship and have no employees These sub-contractors have g. Q Demolition
working for me in any capacity. employees and have workers' 9. Q Building addition
[No workers' comp. insurance comp. insurance.',
required. 5. Q We are a corporation and its 1().Q Electrical repairs or additions
q 1
1 Q I am a homeowner doing all work officers have exercised their I 113 Plumbing repairs or additions
myself. No workers'comp- right of exemption per MGL
I F 12.0 Roof repairs
insurance required.1 * c. 152_ §1(-l).and we have no j
employees. JNo workers'
comp_ insurance required,I ae
'Any applicant that checks box vt must also fill out the section below showing their worker%*compensation policy information.
'lfomcownees who submit this affidavit indicating they are doing all work and than 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-contractor;and stale whether or not those entities have
antplovees. If the sub-contractors hai,e emplovc es.then must provide their workers-comp.policy number.
I am an employer that is providing workers'compensarwn insurance for my employees. Bel~is the polio`and job site
information.
Insurance Company Name:_ co/', ,O L _
Policy #or Self-ins. Lic. #: (9 ZZU 07I 15_-O-U Expiration Date. I q ()
Job Site Address Vc,nee y- ei,-u fit!`— City/State/Zip: Fi nc*, XA- 010tp"'),
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 25.6.of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to S 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$25().(X)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 under the pains and penalties of per jury that the information provided above is true and correct.
Sigrtature:7 44 o,o a��, M�Akd Date:l for C
Phone#: t L22-
Official use ono% Do not write in this area,to be completed by city or town official
City or Town: Pennit/License#
Issuing Authority(circle one):
1. Board of Health 2. Building Department 3.City/Town Clerk -I. Electrical inspector 5.Plumbing Inspector
G. Other
Contact Person: Phone#:
t
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder: AUK p `(�:5 :51-/ (�
License Number 4 do
Address Expiration Date
lal)Al::�I
Signature Telephone
9.Realstered Home Improvement Contractor: Not Applicable ❑
Ir�ley- 78L
Company Name Registration Number
Address J Expiration Date
) l� �� Q-�- Telephonec6qq5_330)
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 Fmit.
Signed Affidavit Attached Yes....... 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 Oft jcial,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 lure 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 aixl State of Massachusetts General Laws Annotated.
Homeowner Signature
t ,
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑
Or Doors C�
Accessory Bldg. ❑ Demolition ❑ New Signs [0) Decks [Q Sidi g M 7 O er[EK
1 U'Q
Brief Description of Proposed
Work: -
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes _No
Plans Attached Roll -Sheet
sa.if New house and or addition to existing housing,cornaiete 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-
1. 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
1, 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
I, 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.
Print Name
Signature of Owner/Agent Date
„
L ,
Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size
Frontage
Setbacks Front
Side L: R L:_ R:
Rear
Building Height
Bldg. Square Footage °ro
Open Space Footage 0r10
(Lot area minus bldg&paved
fl of Parking Spaces
Fill:
(volume&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO 0 DONT KNOW YES
IF YES, date issued::
IF YES: Was the permit recorded at the Registry of Deeds?
NO DONT KNOW 0 YES 0
IF YES: enter Book Page; and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW 0 YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained 0 Obtained 0 , Date Issued:
C. Do any signs exist on the property? YES 0 NO 0
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:
E. Will the construction activity disturb(clearing,grading,excavation,or filling)over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES NO 0
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
Department use only
City of Northampton Status of Permit:
Building Department Curb Cut(Driveway Permit
212 Main Street Sewertseptio Availability
Room 100 WaterMiall Avvailability
Northampton, MA 01060 Two Sets of Structural Plans
phone 413-587-1240 Fax 413-587-1272 Plot/Site Plana
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
'40, t'c?;(wev— _ Map Lot Unit
�(ca2Pti�Pr m C3 O Zone Overlay District
Elm St District CS District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Name(Pri nt) Current Mailing Address:
Telephone
Signature
2.2 Authorized Aaent: II
/ i) Co ST A�
Name(Print) Current Mailing Address: i Q1�
c r t I 1-7
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed b rmit applicant
1. Building (a)Building Permit Fee
2. Electrical (b)Estimated Total Cost of
Construction from 6
3. Plumbing Building Permit Fee
4. Mechanical(HVAC)
5. Fire Protection -t7j
6. Total=0 +2+3+4+5) ), Check Number
This Section For Official Use Only
Date
Building Permit Number: Issued:
Signature:
Building Commissioner/Inspector of Building.: Date
40 PIONEER KNOLLS BP-2009-0513
GIS#: COMMONWEALTH OF MASSACHUSETTS
Ma :Block: 29-034 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Categoa: BUILDING PERMIT
Permit# BP-2009-0513
Project# JS-2009-000719
Est. Cost: $3850.00
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class_ Contractor: License:
Use Group: DAVID S MEIER 159784
Lot Size(sq. ft.): 11979.00 Owner: RYAN GRACE S&JAMES M RYAN&CHRISTINE H RYAN
Zoning_URA(100)//WSP Applicant. DAVID S MEIER
A 40 PPNE_7:n i<�.if?! ! R .
vim
Applicant Address: Phone: Insurance:
108 1/2 COLUMBIA ST (413) 743-3501 we
ADAMSMA01220 ISSUED ON:1111412008 0:00:00
TO PERFORM THE FOLLOWING WORK.-INSTALL PELLET 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-t1 Foundation:
:Driveway Final:
Final: Final:
Rough Frame:
Gas: Fire Deaartment Fireplace/Chimney:
Rough: Oil: Insulation:
Final: Smoke• Final: O K 7.d T-'i�
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
,. .
Certificate of Occupancv. signature:
FeeType: Llfate Paid: Amount:
Building 11/14/2008 0:00:00 $25.005422
212 Maid Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo