36-179 (9) Floor Protector Combustion Air
The stove may be installed on a combustible floor provided Intake or combustion air can be supplied to the stove in one
noncombustible ember protection is used. of two ways. Consult your local building code or CAN/CSA-
This protection must extend as follows: B365, Installation Code for Solid-Fuel-Burning Appliances
and Equipment before proceeding.
In Canada: 18" (457 mm)on the firing side and 8"(203 mm) 1. Outside air supply-(Necessary for mobile home instal-
to the other sides.See Figure#3, below. lation, optional for residential installation.) Outside air
may be drawn from either underneath the stove or from
behind.
FIG.#3 Canada Only To draw outside air through the floor,leave the 4"(100mm)
knockout or cover plate in place in the rear of the pedestal
Minimum Width-40'(1.02m) or leg kit ash box enclosure.
Minimum Overall Depth-50 1/2"(1.28m) Pedestal Model: Cut or drill a 4"(100mm)diameter hole
- - - in the floor anywhere inside the perimeter of the pedestal.
8" [203mm] Cover the hole with a 4" x 4" (100 mm x 100 mm) rodent
screen and staple/nail in place.
Leg Model: Cut or drill a 4"(100mm)diameter hole directly
below the bottom hole of the ash box enclosure. Connect
enclosure to the floor with a short 4"(100mm) diameter
E
pipe.If you wish to connect the outside air to the rear hole
N on the ash box,then remove the 4"(100mm) knockout or
cover plate at the rear of the ash box.
00
This hole must get its air from a ventilated crawl space
or be extended with duct to the outdoors(see Figure#3,
7� Page 7). The use of outside combustion air for residential
3 installation requires the unit to be secured to the structure
18" [457mm] to prevent dislodging of the air duct.
Non-combustible I To draw outside air from behind the stove, an outside air
floor protector t adaptor may be required (see Optional Blower section).
Cut or drill a 4"(100mm) hole through a wall behind the
unit.Use an appropriate household 4"(100mm) inlet.You
In USA: 16" (406 mm) to the front and 8" (203 mm) to the must remove the rear cover plate from the pedestal or
sides of the fuel loading door opening. See Figure#4,below. move the cover plate at the rear of the leg kit ash box
This protection is also required under the chimney connector enclosure to cover the bottom hole.
and 2" (51 mm) beyond each side.
Note: This unit is not designed to be operated with the firing
door open. In addition to the obvious hazard of sparks
FIG.#4 U.S.A. Only landing on combustibles, an open fire door will cause
the heater to draw air from the living space and possibly
Minimum Width-34"(864mm) cause suffocation.
Minimum Overall Depth-40 1/2"(1.03m)
- j Non-combustible 2. Room air supply-Remove the cover plate from the rear
-- - of the pedestal or leg kit ash box enclosure. The stove
floor protector will now draw its air from the room through this opening
r�
and into the firebox intake.
C9 Note: The living space around the heater must be well
N j ventilated with good air circulation. Anything that may
cause a negative pressure can cause gases or fumes
.� •.
{ to be pulled into the living area. During extremely cold
4 J� weather,and especially when burning at very slow rates,
the upper parts of the exposed chimney may ice up,
partially blocking the flue gases. If blockage occurs,flue
N gases may enter living space.
16"[406mm]
CC)
--
10 SUPER-S D 1 PACIFIC 050515-24
ENERGY
Y7ze Commonwealth ol'Massachusefts
Dqpartuzent of IndustrialAccidents
Office of hivesdgations
7 Comeress Street, Suite 100
Boston, MA 021-74-2 017
-wwiv.nzass.,-ov1dia
-V-Vorlkers'Compensation Insura nee Aff Wavit: Builders/Contractors/Ei lectildanslPlumbers
Applicant haformation Please Print Legibly
Name
3- (Business/Orqanizafion/Indi,,idual): AFS d/b/a THE FIRE PLACE
Address:106 STATE ROAC,
MA 01093 Phone-4:413-397-3463
A
1-e vou an employer? Check the appropriate box: Type of project(required):
_ember.with 10 4- ❑ 1 am a general contractor and I
an Qdlhave hired the sub-contractors 6- ❑New construction
ve�s (511[anor pat-t-time).
7 listed on the attached sheet_ 7. ❑Remodeling
- am a sole P-iopnecor or pwmer-
i averio employees These sub-contractors have Demol,
0 S. Ition.
ing For me in any capaci employees and have workers-
9. ❑ Building addition,
-orkers' comp- insurance comp. insurance.;:
-FcQuircd.1 5. ❑ We are a corporation and its 10-F]Electrical repairs or additions
1 7 officers have exercised their
work repairs 0:r add:donis
Lim a homeowner doing all 'n
I I-ElPlumbing rep
myself. [No workers' comp- right of exemption periMOL
?.F-1 Roof repairs
Insuricc rcquired.] c- 152, §1(4),and we have no
h
employees- [No-workers= 13TJ Other
comp-insurance required.]
ttAnN,anDlicaritthar checks box=l must also fill out the section belo-kLshowin-their,%Yoriers'compensation policy in'Jormatijop.
Hotueowner-,w-ho submit this affidavit indicatint:they are doing all work and then hire outside contiiLfa5 must submit a new,affida-,dt indicating.such.
>Contractors that check this box must auaclied,an additional sheet showing die name of the sub-contractors and state whether or not those entities PMV�
aniolovecs- If the sub-contracrors have employees,they must provide their workers'comp.policy number-
.T aw air enrpkyer that is providin-W01-keFs'c07)7PeRSffd0H ins7l"anceJor MY eIVIOYEss. Belolv is the po idiob
an SiTE
infornzatiOR.
Insurance Company -Nlame:MA RETAIL MERCHANTS WC GROUP INC
Policy r or Self-ins- Lie. 014005033601114
Ex-oiration Date:
Job Sitz Address: C?5- City/State/Zip: Flo re-ACz— M/4 0 09 �R
knach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).
Paikire co secure coverage as required tinder Section 25A of MGL c- 152 can lead to the imposition of'criminal penalties of a
rine 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 ro S250-00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Offiffice of
in-vesriLrations ot"the DIA for insurance coverage verincation-
Idoherebyeertifyzindel zepains and Pe12a1tiSS ,Pe11 fury that the information provided above is true and Correct.
P�
Sig-nature " Date:
Phone 413-397-3463
Qj`7cial rise only. Do not write in this area, to be completed by city of town official.
U: v or-To,,,,,n: Permitqicense'I
Issuing.A,uthority(circle one):
n
1.Board ofHealth 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing inspector
6. Otlier
Contact Person: Phone#:
City of Northampton
Massachusetts w r
NT OF BUILDING INSPECTIONS
$ ~ 21 Man Street • Municipal Building
.r : . Northampton, MA 01060 rr+<
a itJSS'cGT10NS
NnUlLC;:^' HSA 10G0
DE 0403T~1F,SS"ON, fl
SINGLE OR TWO FAMILY SOLID FUEL APPLIANCE PERMIT APPLICATION
FOR WOOD, COAL, PELLET, CORN, STRAW OR SIMILAR STOVES. OR FIREPLACES
Check# /�6 1,9-
Please fill in all appropriate information
1. Name of Applicant : `1/4c c-�� � ��CC-
Address: /�L J'f�� '`t�� h ��/� yn Telephone:
2. Owner of Property /�/�'rLCt-"'�•i JU� ��'
Address: s/J� T �' rlvrenec 0/0 C Telephone: c//-S 5W-X79}�
3. Status of Applicant : Owner Contractor
4. Type or Brand of Stolh `e�.-
ve : �4 i /JC tAn--q �v�,-r P / u'
5. Estimated Cost '. 11 1;20. CD
If applicant is not the homeowner::
Contractor name /D007/'(S
Construction Supeniisor's License Number Expiration Date
Home Improvement Contractor Registration Number /A7 77 Expiration Date
All Applicants must complete a Workers Compensation Insurance Affidavit before we can issue a permit
6. Certification: I hearby certify that the information contained herein is true and accurate to the best of my
knowledge.
DATE: �" 30`/ APPLICANT'S SIGNATURE
DATE: HOMEOWNER'S SIGNATURE
APPROVED
DATE: BUILDING OFFICIAL
95 DUNPHY DR BP-2016-0994
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 36- 179 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-2016-0994
Project# JS-2016-001682
Est. Cost: $2200.00
Fee: $40.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: BERNARDSTON FARMERS SUPPLY 99401
Lot Size(sq. ft.): 14984.64 Owner: PYSZ CHARLES S JR&KATHLEEN A
zoninc: Applicant: BERNARDSTON FARMERS SUPPLY
AT. 95 DUNPHY DR
Applicant Address: Phone: Insurance:
43 RIVER ST (413) 648-9311 O WC
BERNARDSTONMA01337 ISSUED ON:2/8/2016 0:00:00
TO PERFORM THE FOLLOWING WORK.INSTALL PACIFIC ENERGY SUPER 27 MODEL
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 2/8/2016 0:00:00 $40.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner