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42-068 Installation H - D USA 6" (152mm) CND 8" (203mm) F USA 6 (152mm) CND 8" B J (203mm) tDoor Opening USA 16" (406mm) CND 118" (4 57mW) E - G C A I Figure Ti:General Parallel Installation ,(refer to Tables 11&12). K tlonai gage L USA.6" (152mm) CND 8" (203mm) P � B Optional Door pening Coverage USA 1 " (406mm) CND 18" (457mm) E Figure 7: General Cbrnehnstallation(refer to Tables 11&13). 19 Installation HEARTH PROTECTION EXAMPLES: Table 11: Examples of Hearth Pad Sizing Using Clearances From Tables 9&10(refer to Figures 22&23). Canada USA 1200 1700 1200 1 1700 (A) Minimum Width (1028mm) 361/2" (926mm) (B) Minimum Depth 46" 50'/2" 42" 46'/2" (1168mm) , (1283mm) (1067mm) (1181mm) OPTIONAL Wner removal (C) Maximum Front Corners - 83/4" (314mm) 63/4" (171mm) Adjacent (D) Maximum Back Corners- Adjacent 6 � 60mm) 5'/s (130mm) (E) Maximum Front Corners - 123/s" (314mm) 91/2"(242mm) Diagonal (F) Maximum''Back Corners- Diagonal 27m m) 7'/4„,(185mm) ax ->-'t (G) Minimum Width remaining 23 (583mm) 23” (583mm) without corners - Front (H) Minimum Width remaining 27 .(707mm) 261/s" (665mrn) without corners - Back w � ,. Table 12: Examples of Parallel Installation Using Clearances From Tables 9&10(refer to Figure 22). Model Country (I) Far Edge of Hearth Pad (J) Front of Hearth Pad to 'fide Wall - Minimum Back Wall - Minimum 1200 Canada = . "(1156mm) 491/4"(1252mm) Single Wall Pipe USA 431h" (1104mm) 471/4" (1201mm) 1700 Canada_ W 7i"(1333mm) 5434" (1391mm) USA, 501/2" (1283mm) 523/4" (1340mm) 1200 Canada!41 112"(1156mm) 481/4"(1226mm) Double Wall Pipe USA 431/2±)(1104mm) 46'/4„(1175mm) 1700 Canada, �2�F 11�� (1156mm) 523/4 (1340mm) USA 431/2"(1104mm) 503/4" (1290mm) Top vent out 1200 Canasta `.4i11a"(1181 mm) 501/4"(1277mm) back wall USA 441/2" (1129mm) 481/4" (1226mm) with min. (610mm) vertical ical 1700 Canadd: 43/2"(1104mm) 553/4"(1417mm) rise; double wall USA 411/2" (1053mm) 533/4" (13466mm) Non combustible floor protection must be under the chimney connector and 2 inches (50.8 mm) beyond each side. 18 ! f 'fi _ Specifications CLEARANCES TO COMBUSTIBLES - 1200 FREESTANDING: MAINTAIN THESE MINIMUM CLEARACES TO UNSHIELDED COMBUSTIBLES* Back wall Adiacent wall PHearth Alcove Back wall B E C N O K A a L H v tA a D a , M 0 Fr n I Alcove Table 2: 1200 Freestanding Clearance to Combustibles. Single Wall Pipe Double Wall Pipe** Top vent out back wall with min. 24" (610 mm)vertical rise; double wall A From side wall 13" 13" 14" to side of unit (330 mm) (330 mm) (356 mm) B From rear wall k 11" 10" 12" to back of unit (279 mm) (254 mm) (305 mm) C From adjacent wall 9" 8" to corner of unit A. (229 mm) (203 mm) D From side wall 22" 22" 23" to collar •(559 mm) (559 mm) (584 mm) E From rear wall 14" 13" 15" to collar (356 mm) (330 mm) (381 mm) F From adjacent wall 171{2" 161/2" to collar (445 Mm) (419 mm) t From door opening USA 16"(406 mm) USA 16"(406 mm) USA 16"(406 mm) to edge of hearth pad CND 18"(450 mm) CND 18"(450 mm) CND 18"(450 mm) H t From side/back of unit USA 6'(152 mm) USA 6"(152 mm) USA 6"(152 mm) to edge of hearth pad CND 8"(200 mm) CND 8"(200 mm) CND 8"(200 mm) Alcove (48"[1220 mm] Deep) I Total Width 55"(1397 mm) Total Height 78"(1981 mm) K Top of stove to ceiling 49"(1245 mm) L Side wall to stove 15"(381 mm) M Side wall to pipe 24"(610 mm) N Back wall to unit 12"(305 mm) 0 Back wall to pipe 15"(381 mm) . 7 13 A M The Commonwealth of Massachusetts Department of Industrial Accidents 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): BERNARDSTON FARMERS SUPPLY Address:43 RIVER STREET City/State/Zip: BERNARDSTON, MA 01337 Phone #:413-648-9311 Are you an employer? Check the appropriate box: Type of project(required): 1.X I am a employer with 4. ❑ I am a general contractor and 1 6. ❑New construction employees (full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8, ❑ Demolition working or me in an capacity. employees and have workers' g y p �'• 9. ❑ Building addition [No workers' comp. insurance comp. insurance.$ required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ 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' 131 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: PEERLESS INSURANCE Policy#or Self-ins. Lic. #:WC8165644 Expiration Date:7/1/14 Job Site Address: City/State/Zip: rtoteAec �'l _Qldg 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 certify u er the pains and p alt' of perjury that the information provided above is true and correct. Si,,nature: 9 Date: � Phone#: 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#: � r 15,ty of Northampton �!4 Si >a''j+♦=^ "� JUN 2 Q 2 Massachusetts =- `-;- f Vag . P;U - OT aV4uiNv .�JFCTr�c tc 62 2 Main Street • MmiciPal Building -.•�:, '� fir- Northampton, M& 01060 GINOLE OR TWO iamiLV sm-in FUEL APPLIANCE PERMIT APPLICATION FOR WOOD, COAL, PELLET, CORN, STRAW OR SIMILAR STOVES, OR FIREPLACE INSERTS Permit Fee: $25.00 Check# dqoq PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant D o vil t S i'O b bzr-- -- 7-A< -'j n� Address. /06 Sit-k 1- b ( )41CL' 0 �f�l Ci C Of07S Telephone: 413 2_ Owner of Property:_ _ 6 J a ln!z Address: 7 G%c N tact lC 2b Ro re px a Telephone: '�/5 9S 4 3- Status of Applicant Owner "'Contractor 4. Type or Brand of Stove: Z':e?V /'p `8 a Yio l / C"0 0 O If applicant is not the homeowner. Construction Supervisor's License Number �� G� Expiration Date Home Improvement Contractor Registration Number Expiration Date 7 Z�-/y All Applicants must complete a Workers Compensation Insurance Affidavit before we can issue a permit 5. Certification:I hereby certify that the information contained herein is true and accurate to the best of my knowledge. DATE: 6 `/`>l'I� APPLICANT'S SIGNATURE DATE: 6 'r 8 r7 HOMEOWNER'S SIGNATURE APPROVED DATE: BUILDING OFFICIAL 27 GLENDALE RD BP-2014-1369 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 42 -068 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: woodstove BUILDING PERMIT Permit# BP-2014-1369 Project# JS-2014-002313 Est. Cost: Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: BERNARDSTON FARMERS SUPPLY 99401 Lot Size(sq. ft.): 17598.24 Owner: TANGUAY DOROTHY M& EUGENE J&WAYNE V TANGUAY Zoning: Applicant: BERNARDSTON FARMERS SUPPLY AT. 27 GLENDALE RD Applicant Address: Phone: Insurance: 43 RIVER ST (413) 648-9311 () WC BERNARDSTONMA01337 ISSUED ON:612312014 0:00:00 TO PERFORM THE FOLLOWING WORK.INSTALL ENVIRON BOSTON 1200 WOODSTOVE 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 6/23/2014 0:00:00 $25.00 212 Main Street, Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner