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25C-006 (8) 134 NORTH ST BP-2017-1033 GIS #: COMMONWEALTH OF MASSACHUSETTS Man:Block:25C-006 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category:Wood Stove BUILDING PERMIT Permit# BP-2017-1033 Project# JS-2017-001777 Est. Cost: $5100.00 Fee: $40.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Grouo: THE FIRE PLACE 99401 Lot Size(so. ft.): 33149.16 Owner: REITER JENNIFER B&ADAM RABB COHEN Zoning: URB(I00)/ Applicant: THE FIRE PLACE AT: 134 NORTH ST Applicant Address: Phone: Insurance: P O BOX 606 (413) 397-3463 () WC W HAT E LY MA01093 ISSUED ON:3/17/2017 0:00:00 TO PERFORM THE FOLLOWING WORK:PACIFIC ENERGY ALDERLEA T6 WOOD 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 ft 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 3/17/2017 0:00:00 $40.00 212 Main Street, Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck--Building Commissioner Cit . *f t MAR 1 6 2017 mar tut z,} meat 'OP Fisifl rwS } f > APtea siesta F..t OlUBV - G 69-/ 7-10.33 S3N 7i�eai?35$0 FAMILY SOLO FUEL APPLtAll s0 SAMTQA.Vg FaRY **t eaL:E.t rAtitS 7AAw 11W,AR F tka-WiEpt4B Pleck0CI .1i3 o flearat tner aapmct »e' r77 +. NameNameoEAttifflL•h ///Ftt.. . //rr 1—i fe / (Ce.—" t)nutltJ I71-ibc-c- ._ . Adtir 06 S{a.l R' �i./ . .tom p1 6-1697. gt?.r±:-t ,... 1 X ' • 0 "4:.acrdaess[ 1 :3F1 /1 -?1, h����..,...,l.n ,n�4 ,;2?a'SvGCr4;..J�� 1,. c„rR�17 3 Statusafrtkitarifarti awmr 417Conttactif 4. Tylagor8ia9d Of Shave �%-L . /, L G n2...i �`S I� �a1ZI f2 "t tU 5” Eatir aled Cost .5700 Oe fiapplicade1S iatoha ame-tz Consactorname.<-7)e574_, 1PaCC. Conatruaua,.8armrS450ea UMW Namber 9°I/a1 . .-, ear er s ate /�6 i.Z FianaltaprO+emattt eronkadorflealstrafort Nardga //e / JO 77_ Expirat on:Data //-r 9-/ P RAnPGl !tatttmustcomphoTe a boar+is Q up..err' ckai cacti atdaaibIM*e alt itsae a pelmft 6. Cmfifl miu theathy?say ihal frfiutui on 6-pn4Inedbersntt'tneamnan1siaA9io tbfleatitalY itnaMatige- CARPE: . • /HI :APFUGA'Nr$s1 - __ - [ATE t) �I l 19oAAE WNFRS$t '.. 1 �� ""^ .' [ l APPROVED 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®(NFI)as Do not connect this wyt NFI woodburning Specialists or who are certified in Canada by Wood Energy to a chimney.the Technical Training(WET!). another applianOt • Outside combustion air or fresh air into the room may be required in your area,consult local building codes(see Combustion Air section). BOTH CHIMNEYSYSTEMAND 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 surfacesand materials using single-wall connectorare shown in Figure#2. Clearances may be reduced with various heat insulating materials.Consult local,National fire codes and authorities for approval. 3. Alternately,for close clearances, use a listed double-wall connector See Figure#2a. Ilii Minimum Clearances to Combustibles — Residential 1775" 229mm � 20.25" 152mm 451mm C—'1 14" -514mm SINGLE WALL ftJ�356mm " /g CONNECTOR 1 II®�� o �,28.]5" a 152mm �� 756mm g#2a Z5" 191mm 18.75 ' 10" 19.25" _ 5' 16.25 13 689mm 413mm I f _ 330mm 476mm, Gmm O 12]mm 6 CO DOUBLE WALL � CONNECTOR 2775" I-oemm -111 p * 705mm 30.]5" ■ 127mm —781mm ALCOVE: Min.Height 7 feet(2.1m) Max.Depth 4 feet(1.2m) 030215-24AL6B 7 ©PACIFIC ENERGY FIREPLACE e PRODUCTS LTD. Floor Protector The stove may be installed on a combustible ire S - Canada Only floor provided noncombustible ember U.S.A. Only Minimum Width -43"(1.09m) protection is used. Minimum Width -363914mm) Minimum Overall Depth-50 1/2(1.28m) This protection must extend as follows: Minimum Overall Depth-401/2(1.03m) In Canada: 18" (457 mm)on the firing side and 8" (203 mm) to the other sides. See { -- Figure#5 on left. I8" (203mm] 1 - In USA'. 16" (406 mm) to the front and 8" I -- — fl/ ©�� door(203 mm)ope to the sideseof the fuel right.ading r ILJ) Ecy door opening. See Figure #6 on right. S This protection is also required under the chimney-connector antl 2(51 mm) beyond each side. • ------ Ill w ,hofiRt �� -y ✓ I € E 18" [457mm] 3 l6"1406mm1 Non-combustible floor protector Non-combustible floor protector m Combustion Air Intake or combustion air can be supplied to the stove in one of two ways.Consult your local building code or CAN/CSA-9365. Installation Code for Solid-Fuel-Burning Appliances and Equipment before proceeding. 1. Outside air supply-(Necessary for mobile home installation, optional for residential installation.)To draw outside air through the floor,cut or drill a 4"(100mm)diameter hole directly below the bottom hole of the ash box enclosure(see page 6 Fig.#la).Connect enclosure to the floor with a short 43100mm)diameter pipe. This hole must get its air from a ventilated crawl space or be extended with duct to the outdoors (see Figure #4. Page 10).The use of outside combustion air for residential installation requires the unit to be secured to the structure to prevent dislodging of the air duct. Note: When installed in a mobile home, this unit is not designed to be operated with the firing door open.In addition to the obvious hazard of sparks landing on combustibles, an open fire door will cause the heater to draw air from the living space and possibly cause suffocation. 2. Room air supply-There is a 4"(100mm)opening in the ash box enclosure.The stove will draw its air from the room through this opening and into the firebox intake. Note:The living space around the heater must be well 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 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 gases may enter living space. fidet� PACIFIC ENERGYLTD. FIREPLACE 12 030215-24 AL6B /r7ga ©PRODUCTS \Y k The Connnotnvealth of Massachusetts l( ( 3 Department ofIndustrial Accidents 1 Congress Street,Suite 100 j ' Boston,MA 02114-2017 www.ntass.got✓dia Workers'Compensation Insurance Affidavit:General Businesses. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly BusinessOreanization Name:THE FIRE PLACE Address: 105 STATE RD Clij Siai2'Zip:\'\'HATELY, MA 01093 Phone#:413-397-3463 A re you an employer?Check the appropriate box: Business Type(required): ec employer evidt 10 employees(full and/ 5. ®Retail _ r -rime)." 6. ❑Restaurant/Bar/Eating Establishment Ll I me a a so:e proprietor or partnership and have no 7. 0 Office and/or Sales(incl.real estate,auto,etc.) employees tcm'king far me in ally capacity. .crkers' comp. insurance required] 5. ❑Non-profit 3.u we are a corporation and its officers have exercised 9. ❑ Entertainment their rieht of exemption per c. 1i2,§1(4),and we have 10.❑Manufacturing. ' co em.pioyees.[No workers'comp.insurance required)°' are a non-profit organization,staffed by volunteers. I I ❑ Health Care wit no employees [No workers' comp insurance req.] 12.0 Other -nn:: int,ICIteCkS box I must also till mtahe meson raory:hot„na me r r.nricers'eempensation mreY 'ttbnnation. "I Int co'=ne,el': rs have exempted themselves,bin the cnmemvon has other employees,a uvrkers'compensation policy is required and such an orcanivation shc916 check box'-I. I am an employer that is providing ram kers'compensation insurance for rnp employees. Below is the policy information. Insurance Company Name:MA RETAIL INC GROUP, INC Insurer's Address:P.O. BOX 859222-9222 City/State/Zit: BRAINTREE MA, 02185 Policy o or Se ins.Lie.#014005033601115 Expiration Date:116/16 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 ofa fine up to SI.500.00 and/or one-year imprisonment,as well as civil penalties in the form ofa STOP WORK ORDER and a fine of up is S250.00 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, refer the painsandpent as of perjury that the information provided shove is true and correct. Signature: R/C.t.c-c-^- �C/. u—r—'t.. Date: '3 / 3' f Phone- 1-413-397-3463 Official use only. Do not write in this area,to be completed by city or town ofcial. City or Town: Permit/License ta issuing Authority(circle one): I 1. Board of Health 2.Building Department 3.City/Town Clerk 4.Licensing Board 5.Selectmen's Office 6.Other Contact Person: Phone ivww, eo ldie