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18C-019 (3)
289 HATFIELD ST BP-2017-0886 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 18C-019 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-2017-0886 Project JS-2017-001501 Est.Cost:$3900.00 Fee:$40.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: THE FIRE PLACE 180477 Lot Size(sq.fl.): 8145.72 Owner: SEGAL ENID L Zoning: SR(I00)/ Applicant: THE FIRE PLACE AT: 289 HATFIELD ST Applicant Address: Phone: Insurance: P O BOX 606 (413) 397-3463 0 WC W HATE LYMA01093 ISSUED ON:1/23/2017 0:00:00 TO PERFORM THE FOLLOWING WORK:PACIFIC ENERGY 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 ‘cry A 5.5 5 Massachusetts flat 1A1 a ,Q. • & DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building Northampton, MA 01060 P- 17- gF(, SINGLE OR TWO FAMILY SOLID FUEL APPLIANCE PERMIT APPLICATION FOR WOOD,COAL,PELLET, CORN,STRAW OR SIMILAR STOVES,OR FIREPLACES Check# IR e(0 Please fill in all appropriate information 1. Name of Applicant : �RC rile %D/eCC (7) 002/Qy L 9b&0- Address: /9r Shtic. /20 it//Lfely nIA o1093 Telephone: I/3 397 394 2. Owner of Property : cJ e7 B/ Address: a89 / effict o 377 Nor-/A, rnpta it Telephone: 3. Status of Applicant : Owner Contractor S�o re AN rylc7n/ q03 4. Type or Brand of Stove : / QP.Yre Lncrgy %c/ Q/dcr7 UL/a 5. Estimated Cost : 3 Sao ¢ If applicant is not the homeowner:: Contractor name ciDou BARS -Ali4zc. Construction Supervisor's License Number 9 91(D/ Expiration Date Home Improvement Contractor Registration Number /e01/17 Expiration Date //-/9-/P All Applicants must complete a Workers Compensation Insurance Affidavit before we can issue a permit 6. Certification: I Nearby certify that the information contained herein is true and accurate to the best of my knowledge. ,4411, DATE. / - / 7- 4 APPLICANT'S SIGNATUR / i DATE. ld'r'rC, HOMEOWNER'S SIGNATURE A, I — r # , APPRDATE a 3 --/ 7 BUILDING OFFICI• • The Commonwealth of Massachusetts _ Department ofIndustrial.4ceidents I Congress Street, Suite 700 __ - - Boston, MA 02114-2017 www.mass.povhlia ll nrker' (fon pensation Insurance Affidavit:Builders/Contractors/Electricians/Plum hers. I I)BG FILb:O l\'17'11 TIIF PERMITTING\I TIIORI T1. \indicant Information Please Print Lee_ihh \font lI4u,me.,rll_:u:i.nal,nl ale idualr THE FIRE PLACE \ddre+a. 106 STATE RD ( it\'Stale /ip:INHATELY, MA 01093 Phone #:413-397-3463 tot.nu an cagll.,.er?1 foie illy l hlprnpriate hu`: Type of project Irequired): I Q l:a arm_ ..ins 10 empl.necs lullnmror pamlme).* 7. ❑Nett conslmcliun :0I hip ahas e no nplmas working forme in S. ❑ Rentoddin_ :\ . pen, p m. 4 ircd I. - )- ❑Demolld. n❑I „ ..,. �i Ilat k - p. wmnce required 1 _ J Pall k I. Ire, II 10❑ Bu kill li llliun : m 6 , compensation rance or are sole I L❑Itlectricai - par or additions 12.0 Plumbing repairs or additions Pip PI, i rel l listed on the attached slice. In..❑ r❑ RoOI repairs n . I.:c II- Iden insurance.: - ane.: 0v l (their h I exemption pa MG, I4.0 Other I - s1.II lna.e.naen.M,a .. IAo er orkcn compinsurance required I b. Il I 1v.1 hat clam him ill.t the ectlon helots shomme the}morkerscompensation pill cr IGrtn matt 'IF e e., :nJc (het reJ 'all stork and then hire side contractors mum submit a nemTJ:e such Ir .PelEP I I. h aJJ1t Ll a hem showing the name oflh soh-contractors d state stlictlior OF a II motile h:ne' hPIC�J-eemoaunn hate unplutvc..1k' most pros ide their worked comp.I»Lcenomher I fon an employer duo is prnridiu# -orAers'compensation insurance for my employees. Br/nre is the polies and job site in/rmnIarino- Insunncc t oilman) 'same:MA RETAIL MERCHANTS WC GROUP p„I t . r ceI6im I.i:. -014005033601116 Expiration Date: 1-1-18 Jcih Slee \ddre,,. F? /7 a %e //1 . CityStateZiAp Al c/66n p.' / rf�o nye "ern \Mach a copy of the wo iters' compensation policy declaration page(showing the policy number and expiration date). failure to secure co)epee as required under MGL 152.§25A is a criminal violation punishable h)aI Site up to S I.500.00 old or oneSear imprisonment_as nett as civil penalties in the form of a STOP WORK ORDER and a Mlle of up to 5250.00 a (la) (coiner the e iHalon V cops til Ibis gatemen(may be forwarded to the Office of Investigations of the I11.A for insurance CO)erage licuwn. /do hereby collie melamine intim and petitesofperjury thtd the infnrmntian provided abort is true and correct. Sienaturc tR = / O—a Date: /' r 7-/ Phone=:413-397-3463 oftidol nye(oilt. Do nut Imre in this area.to he completed by city or town official. ( iiv Pr hitt it: Permit/License# Issuing \u thorn: 'circle Pile): I. Baa rd of IIcahh 2. Building Department 3.City/Town Clerk 4. Electrical Inspector 5. Plunshin_Inspector 6.Other (Maar 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®INF!)as Do not connect etis unit Y, NFI woodburning Specialists or who are certified in Canada by Wood Energy ` t0a n Technical Training(WETT). t . CFf r a, s8 mother .L • "Iw' eAtiirrt • 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 SYSTEM AND 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 tocombustiblesudacesand materials using single-wall connectorare 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. ICBM Minimum Clearances to Combustibles — Residential Fes Ars rap reSSEPX549,7 5" 10" 2075" 1381mm 22.625" 254mm 527mm 14,. 575mm- SINGLE WALL GI Q 356mm /O CONNECTOR —66omm zsamm 7% Fg#2a 7 178mm rfiepre /////OOI////Ol///p//%p//////%; \ 12.75 12.75' 279mm 39)m&76mm 18]5" 11" 15.625 3" 324mm IEJ _-324mm, 426mm \U IL os m 00 DOUBLE WALL z" CONNECTOR 24" 3osmml�dl 3"m _ 610mm - p4• 76mm 610mm ALCOVE: Min.Height 7 1/2 feet(2.29m) Max.Depth 4 feet(1.22m) 080515-24 ALTO ©PACIFIC ENERGY FIREPLACE7 r/11 PRODUCTS LTD. �` J SPARK ARRESTOR ---- , RAIN CAP 1 — CHIMNEY 0'(914 mm) MINIMUM -------,-,,, '-..STORM COLLAR RADIATION SHIELD ` .., ROOF FLASHING The chimney may incorporate an � �� -------.....,„:•-h--...-------.....,„:•-h--.....,__� offset.To do this safely,all sections t �� of listed connector, offset elbows and chimney section must be CHIMNEY SUPPORT screwed together by at least three MINIMUM 7'(2100 mm) sheet metal screws per joint.The CEILING HEIGHT chimney must be sui tably supported by the chimney manufacturer's 563140(1441 ram) CHIMNEY CONNECTOR listed offset support. It T —_y, 48° (1219 rem) ` Din NON-COMBUSTIBLE y / FLOOR PROTECTOR , 1 ` HOODED VENT OR /� _ 90°ELBOW TURNED DOWN ` 4"(IOOmm)diameter air inlet with rodent screen- Vi ' If the crawl space is well ventilated it is not neces- sary to extend air inlet to outside I f7lf ©PACIFIC ENERGY FIREPLACE yO 080515-24 ALT4 ,;Y� PRODUCTS LTD.