29-250 (3) 126 OVERLOOK DR BP-2017-1309
GIS 4: COMMONWEALTH OF MASSACHUSETTS
Map:Block:29-250 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-2017-1309
Project JS-2017-002167
Est.Cost: $4000.00
Fee:$40.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: THE FIRE PLACE 99401
Lot Size(sq. ft.): 25831.08 Owner: MORTON RICHARD S&JOYCE M
zoning_ Applicant: THE FIRE PLACE
AT: 126 OVERLOOK DR
Applicant Address: Phone: Insurance:
P O BOX 606 (413) 397-3463 0 WC
WHATELYMA01093 ISSUED ON:5/11/2017 0:00:00
TO PERFORM THE FOLLOWING WORK:HARMEN 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 k 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 5/11/2017 0:00:00 $40.00
212 Main Street, Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
,
City of Northampton
rr Massachusetts 4/ � 'Cr
* F
III • I . €0 i DEPARTMENT OF BUILDING INSPECTIONS D +6T >.,
Cr, 4, 212 Main Street • Municipal Building O
+,Y e Northampton, MA 01060 .�i o. \ \
6,-/ 7,7309 �Ve
SINGLE OR TWO FAMILY SOLID FUEL APPLIANCE PERMIT APPLICATION \\\�
FOR WOOD,COAL,PELLET,CORN,
# /�/g5 R$TOV�S,OR FIREPLACES�9' �50
Pleaseefill in all appropriate information
1. Name of Applicant: 7a07/o1 / Wh6 rt. - 7Ac O`rrc 7/< f'c
Address: /06 SA' - %20 Whiny /I1 °lep3 Telephone. 4//3 377 3965
2. Owner of Property : joy Cc 1711 og1-o4
Address: /36 Ovcr/oa/4 De, F/0rcnec Telephone: 511.- 5-84, -t{/2.9
I
3. Status of Applicant : Owner t/ Contractor
4. Type or Brand of Stove : b'nmq n ?‘//Q
5. UL Listing : (/L/9,,x//'9
47
6. Estimated Cost: 000. °'
7. Email :
If applicant is not the homeowner:: / // L ,.�,
Contractor name 7)005'/e3 L Ah4'C Email : 01007/tO herbs r'cf 5/0/1'rArr3 S0p7 1y etf'
Construction Supervisor's License Number 9990/ Expiration Date /'6 -/ i
Home Improvement Contractor Registration Number r eR0 5177 Expiration Date //-/ 9-/ P
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: Y - ze./ APPLICANTS SIGNATURE --------C---_
/
DATE: i''/f'/.7 HOMEOIYNER'S SIGNATURE 2 / .IL^ -
APPROVED '//�, ?r/,
DATE: 57(— / f 9J',L:;'\O CEEiO1•.. !/
The Commonwealth of Massachusetts
Department of Industrial Accidents
1 1 Congress Street,Suite 100
Boston, MA 02114-2017
www.mass.gov/dia
Workers'Compensation Insurance Affidavit:General Businesses.
TO BE FILED WITH THE PERMITTING AUTHORITY.
Applicant Information Please Print Legibly
Business/Organization Name:THE FIRE PLACE
Address: 106 STATE ROAD
City/State/Zip:WHATELY, MA 01093 Phone#:413-397-3463
Are you an employer?Check the appropriate box: Business Type(required):
I.Q I am a employer with 10 employees(full and/ 5. ❑Retail
or part-time).* 6. ❑Restaurant/Bar/Eating Establishment
2.g I am a sole proprietor or partnership and have no 7_ ❑Office and/or Sales(incl,real estate,auto,etc.)
employees working for me in any capacity.
[No workers' comp. insurance required] $ Non-profit❑
3.❑ We are a corporation and its officers have exercised 9. ❑ Entertainment
their right of exemption per c. L52,$I(4),and we have 10.0 Manufacturing
no employees. [No workers'comp.insurance required]"
4.❑ We are a non-profit organization,staffed by volunteers, I L❑ Health Care
with no employees.[No workers'comp, insurance req.] 12.0 Other
Atilt applicant thai checks Nix S I must also rill out the section Felon showine their morkers compensation polies information.
"If the corporate officers have exempted themselves hut corporation has other employees.a eorkers compensation policy is required and such an
oreameation should check box:I.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy information.
Insurance Company Name:MA RETAIL WC GROUP, INC
Insurer's Address:P.O. BOX 859222-9222
Cit) State/Zip: BRAINTREE, MA 02185
Policye or Self-ins. Lie.e;014005033601115 Expiration Date:1-1-18
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
Zine up to S1.500.00 andor one-year imprisonment,as well as civil penalties in the form ofa STOP WORK ORDER and a fine
of up to 5250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Inxesrieations of the DIA for insurance coverage verification.
I do hereby certify.r der the pains and penal s of Kury that the information provided above is true and correct.
Signature: Date: ‘574
Phone 1/13- 371- 34 "3
Official use only. Do not write in this area,to be completed by do:or town official.
City or Town: Permit/License#
Issuing Authority(circle one):
I. Board of Health 2.Building Department 3.City/Town Clerk 4.Licensing Board 5.Selectmen's Office
6.Other
Contact Person: Phone#:
mug mass eav,dia
B. Clearances to Combustibles Place the stove away from combustible walls at least as far
When selecting a location for the appliance it is important to as shown in Figure 3.2. Please note the difference in side
consider the required clearances to walls (see Figure 3.2). wall clearance with and without side shields.
Notethat the clearances shown are minimum for safety but do
AWARNING not leave much room for access when cleaning or servicing.
Please take this into account when placing the stove.
RISK OF FIRE OR BURNS! Provide adequate Due to high temperatures. the stove should be placed out of
clearance around air openings and for service traffic and away from furniture and draperies.
access.Due to high temperatures, the appliance should
be located out of traffic and away from furniture and Children and adults should be alerted to the hazards of high
draperiessurface temperatures and should stay away to avoid burns
to skin and/or clothing.
Young thildren should be carefully supervised when they are
ACAUTION in the same room as the stove.
Clothing and other flammable materials should not be placed
THIS APPLIANCE MUST BE VENTED TO THE OUTSIDE. on or near this unit.
NONCE:illustrations reflect typical installations and are FOR
DESIGN PURPOSES ONLY Actual installation may vary due
to individual design preference.
P61A&P68 Freestanding Pellet Stove P43 Freestanding Pellet Stove
•
f4"(355mm) with 2"(6, *10"(254mm)with 2"(SYmm)_
•
side shields ______.,,,__,__ \ side shields
20"(508mm1I 16'{406± ?)
without side shields without side shields _,j Y0"(254mm}
t4"(355mm) -
20"(508mm) '16"(406mm)
1 _• —..........
I
367914tren) 38"(914mm)
9"(228mm), 9"(228mm)
13"(330mm)
\‘;
\�
ti
90
LI
9"(228nen)With Side Shields
3
131330mm) Without Sad; Shields 9"(228mm)With or Without Ste Shreids
Figure 3.2
9 Harman® - P-Series Installation Manuai_RS - 2014- " 04115 3.90-436168i
•
C. Floor Protection D. Mobile Home Installation
Place the stove on a noncombustible type floor or floor When installing this unit in a mobile home, several
protector that extends a minimum of 6 inches (152mm) to requirements must be followed.
the front of the load door opening, 6 inches (152mm)to the 1 The unit must be bolted to the floor.This can be done with
sides of the door opening. and 6 inches to the rear. Floor 1/4" lag screws through the 2 holes in the base plate.
protection must also extend 2 inches (51mm) beyond each
side of any horizontal flue pipe.The P-Series do not require 2. The unit must also be connected to outside air. See section
R value floor protection.The minimum floor protector material 4-O Outside Air
is 20 gauge sheet metal. Other floor protector materials that 3. Floor protection and clearances must be followed as
can be used include Type I hearth pads. ceramic tile, stone, shown.
brick. etc. Figure 3.3 4. The appliance must be properly grounded to the frame of
NOTE for Canadian installation only: Per ULC-S627-00. the mobile home using a minimum of 8AWG copper solid
If installed on a combustible floor. the need to provide a or stranded, insulated or bare wire or equivalent.
noncombustible floor protector covering the area beneath
the space heater and extending at least 17.72" (450mm)on
the firing side and at least 7.87"(200mm)on the other sides.
In Canada,you may follow smaller U.S.floor protection
requirements ONLY if the user agrees to completely
shut-down the appliance, and allow it to cool to where
all fire is extinguished and the combustion blower and
its indicator light shuts off, prior to opening the firebox
door or ash door.
P43-Minimum size rectangular floor protection (USA) is 32-1/2" Wide by 22" Deep (838mm X 825mm).
P61A - Minimum size rectangular floor protection (USA) is 24-3/4" Wde by 28-5/16' Deep (629mm X 719mm).
P68-Minimum size rectangular floor protection (USA) is 25" Wide by 33' Deep (635mm X 838mm).
"Floor protection dimensions for the front and sides are measured from the appliance door opening in The United States. In
Canada. the side dimension is measured from the widest part of the appliance.
Floor Protection �
Requirements US Canada I Corner to edge dimension for corner installation floor protection.
,J Sides 6" 200mm
K Front 6 450mm
•
L Rear 6 200mm:
NOTE: Measurement L is measured from P4zs,s
P61P'PE8=50
the pedestal base in the US ONLY
NOTE: Measurement K' is measured from
the glass in the US ONLY
L
1._
Alternate floor protector dimension maybe used as long
as they satisfy the measurement requirements shown
below.
CANADA Minimum size floor protection for a corner installation
hearth pad is 36" x 36" (USA ONLY). NOTE: Floor
•
•
>____.. . protector WILL NOT touch the wall.
J K
USA _ r.„ •:_
Figure 3.3
10 Harman® - P-Series Installation Manual_R8 • 2014-
_ • 04/15 390-4361681