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11-003 (2) 79 COUNTRY WAY BP-2017-0885 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 1 1 -003 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-2017-0885 Project# JS-2017-001500 Est. Cost:$4600.00 Fee: 540.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: THE FIRE PLACE 180477 Lot siie(sq. ft.): 23391.72 Owner: VOLPE ELENA Zoning: Applicant: THE FIRE PLACE AT: 79 COUNTRY WAY Applicant Address: Phone: Insurance: P O BOX 606 (413)397-3463 O WC W HATELYMA01093 ISSUED ON:I/23/2017 0:00:00 TO PERFORM THE FOLLOWING WORK:PACIFIC ENERAY T4 ALDERLEA 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 1/23/2017 0:00:00 $40.00 212 Main Street,Phone(413)587-1240, Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner City of Northampton 0 e`-- us Massachusetts DEPARTMENT OF BUILDING INSPECTIONS � E 212 Main Street • Municipal Building J / Northampton, NA 01060 SnYN, M01" Pee 60 r7 - g6" M SINGLE OR TWO FAMILY SOLID FUEL APPLIANCE PERMIT APPLICATION N FOR WOOD,COAL, PELLET,CORN,STRAW OR SIMILAR STOVES,OR FIREPLACES Check# /L/ 2 f/ // , /a Please fill in all appropriateropinformation /P '<f 1. Name of Applicant : '/hc l'c7A-c.p /_/oo7/4S Address: /CC '.S374--/a /qj (1/A¢1 (/ MM Telephone: `//3 . 9% s /4 2. Owner of Property : f/A/Ln U d Address: 77 ( oCP/i 1A_, ricre/Ir-e PIA Telephone: V/" 4V C-9/97 /06 3. Status of Applicant : Owner Contractor 60,/A t 4. Type or Brand of Stove : ` free; /c / y dicier/re.— / rncfni h.�S'(� . YP { 17k-rely C At rn ne.) 5. UL Listing : (/U ti,fo't 6. Estimated Cost: tc 00.CO 7. Email : If applicant is not the homeowner:. Contractor name 7Di0yfts L Ah Email : [i06 Ca brr Aare( Sl4h fir/xrr> Construction Supervisor's License Number c)?VO/ Expiration Date l' . -/ Home Improvement Contractor Registration Number /PCP V t? Expiration Date //-/9-71 All Applicants must complete a Workers Compensation Insurance Affidavit before we can issue a permit 8. Certification: I hearby certify that the information contained herein is true and accurate to the best of my knowledge. DATE: /- /9-/7 APPLICANTS SIGNATURE —i.°. __.. -- —' - --- -. — DATE '/‘ HC'E0'Y,NERS SIGNATURE APPROVED �J 7 �� DATE: p` / l _.. • The Commonwealth of Mtn'sac(utsetts Department ofIndustrial.4ecidents 1 Congress Street, Suite 100 Boston,MA 02114-2017 www.massgov/tlia porker.' (um pensation Insurance Affidavit: Builders/Contractors/Electrieia a e/Plumbers. l()1W 111.10\\ITII"f11E PER\IIITI[G%I TIIOR1 Il'. \pplitant Information Please Print Legible \alne n lnswess 1 heviisau.m InJn ida.dl:THE FIRE PLACE \JJress. 106 STATE RD ( in 5c to /ip:WHATEiLY, MA 01093 Phone#:413-397-3463 t.. nut),.., 11 ,k dlt apprrpri.le ho. 'lope of project lrequired): I .,I 10 .iiiimitees Hun antharpart-time)• 7. ❑ A n.iruetion 2❑Imai ..slur I'max c no tiepininking Grmeim 8. ❑ R InndcGmi_ mm - q red I -❑I ,,,i) , ql Ix .kers p ranee required] 0- ❑ Dc nol'wm ❑I ,fl - I nd baall k properrr Iwill Io❑ null ) , : 11r II ., ..� h. -, ,pen n 'rain oro s,leIL❑CI ct cl -gyp( or addtinn, m..-..n — I2.0Pltl Ibim repair.or addition. ❑ I listed On theaached shell ❑ , n . , .11\1111.11C'..rtc mP nsc inner : RnofIepmo . ❑tt, ..„J the it re•emption per M(H-e. 14.❑Odic' Jiii ;n. 'Am co np insurance required I A til I Iv M1.. 3.•III I the m below shoe ne.them morker• onmen•Jbepale :I rn.Nm: II n .. 1.1111..11111,: hu reJo ' all work and thenmsdeunrl ' nstseln1; IkLi ..IL u �I . such . I .I s.nh 1.. .d.111.1ddlt1011.11sheetshaming the 11 M sreunen - dsmres:hule . .ee'ni ho'. m , rnm, Lnn.. con bb liu‘c nnphnm lheln a Pro.ide their workers comppolio number. /wn an employer that ie pruridingr anrken'compensation insurance for nm employees. Belem is the puller aout Joh sire tole),nroti In. Insurance ( ompam ume. N1A RETAIL MERCHANTS WC GROUP P. Ii:. -nr ser Hi], Inc. - 014005033601116 Expiration Date:1-1-18 Jub Site.A 79 co Airy tic‘y - Cn T'smelZip. r/or ac— int) cane % idiacop) of the wmke's' compensation policy declaration page(showing the policy number and pi rat con date). 1 lin.cam-uncn_e as required under MGL c. 152.§25A is a criminal violation punishable bs i Ilse tip to SL500.0n and or enc-'co:inlprmonmcnl.uh'sell as eicil penalties in the form of a S'fOP WORK ORDER and a fine of up to SIs1)OO a Ja' ,Ca esb the :h,ahr. \a'p' nf111k statement may be forwarded to the Office of Investigations of the DI for insurance eeti tee'en IIid11J11. I do hereby eeniJi'Unde, he pains and penalties fperjury that the information provided above is true and evrrett. Sisn_,uun: t-e-A- 2 Date: 7” / 1"/g.. flues ,..413-397-3463 Official use null. no not write in tris area.to be completed by city or town official. (-ire or linen: Permit/License# Issain_ Aathunll fintie one): I. Board of I Iealth 2. 13wiIding Department 3.City/Town Clerk 4. Electrical Inspector 5. Plum bino Inspector 6.Other (-(intact Person. Phone#: Installation - Residential Warning: Under no circumstances is this heater to be installed in a makeshift or"temporary"manner. It may be fired only after the stove is installed properly. • DO NOT ATTEMPT TO CONNECT THIS HEATER TO ANY AIR DISTRIBUTION DUCT. • We recommend that our woodburning hearth products be installed and serviced by professionals who are certified in the U.S.by the National Fireplace Institute'(NEI)as Do not connect this unit NFI woodburning Specialists or who are certified in Canada by Wood Energy to a chimney flue serving Technical Training(WETT). another appliance. • Outside combustion air or fresh air into the room may be required in your area,consult local building codes(see Combustion Air section). BOTH CHIMNEY SYSTEMAND CONNECTOR MUST BE LISTEDTO:IN CANADA - ULC S-641 LISTED CONNECTOR AND ULC-S-629 LISTED CHIMNEY,IN USA - UL-103 HT LISTED CONNECTOR AND CHIMNEY Clearances — Residential 1. This heater may be installed using a single-wall connector(smoke pipe)or listed double- wall connector(see Mobile Home installation). 2. Clearances to combustible surfaces and materials using single-wall connector are shown in Figure#2. Clearances may be reduced with various heat insulating materials. Consult local fire codes and authorities for approval. 3. Alternately,for close clearances,use a listed double-wall connector. See Figure#2a. 2 Minimum Clearances to Combustibles — Residential 2075' 1381mm raga 625' 254mm 527mm , SINGLE WALL DSD 3ssmm �► CONNECTOR OQ 26- 6 '254mm 60mm 178mm 11" � 15.625", 3' 1275' 1275 16.55 279mm 1, 397mm V 176mm 324mm (� 7`�-324m , / 426mm l• � I� 1soemm� Q DOUBLE WALL �LJL 12 CTO 1,30 ` CONNECTOR610a'm 4305mm 24 76mm (-610mm ALCOVE: Min.Height 7 1/2 feet(2.29m) Max.Depth 4 feet(1.22m) 080515-24 ALTA 7 ©PACIFIC ENERGY FIREPLACE an 1 , PRODUCTS LTD. Dna SPARKARRESTOR RAIN CAP al ri' u CHIMNEY 3'(914 mm) MINIMUM STORM COLLAR RADIATION SHIELD \�--------ROOF FLASHING 11 I The chimney may incorporate an f offset.To do this safely,all sections 1 of listed connector, offset elbows and chimney section must be CHIMNEY SUPPORT screwed together by at least three MINIMUM T(2100 mm) sheet metal screws per joint.The CEILING HEIGHT chimney must be suitably supported by the chimney manufacturer's 563/4"(1441 mm) CHIMNEY CONNECTOR listed offset support. I 1 14:(1219 mm) jl l.. NON-COMBUSTIBLE FLOOR PROTECTOR 11 HOODED VENT OR / 902 ELBOW TURNED DOWN * 4" )diameter air Inlet with rodent screen, ` If thehe crawl space is well ventilated it is not neces- sary to extend air inlet to outside ©PACIFIC ENERGY FIREPLACE 10 080515-24ALT4 PRODUCTS LTD.