12C-066 (7) 21 HAROLD ST BP-2017-1339
GIS#: COMMONWEALTH OF MASSACHUSETTS
Man:Block: 12C-066 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-2017-1339
Project# JS-2017-002216
Est.Cost: $2300.00
Fee: $40.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: THE FIRE PLACE 180477
Lot Size(sa. ft.): 10062.36 Owner: STRACCO PAUL&HELENE
Zoning:Rl(I00)URA(100)/WSP(100)/ Applicant: THE FIRE PLACE
AT: 21 HAROLD ST
Applicant Address: Phone: Insurance:
P O BOX 606 (413) 397-3463 O WC
WHATELYMA01093 ISSUED ON:5/22/2017 0:00:00
TO PERFORM THE FOLLOWING WORK:TRUE NORTH TN2OL 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 St 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 Occu•anc si•nature:
FeeType: Date Paid: Amount:
Building 5/22/2017 0:00:00 $40.00
212 Main Street, Phone(413)587-1240, Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
City of Northampton
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= A:el.:S p= a =SL1•,+C INSPECTIONS I d p
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SINGLE OR TWO EARL Y SOLID FUEL APPLIANCE PERMIT APPLICATION
FOR WOOD.COAL.PELLET,CORN.STRAY.'OR S1:,::LcS STC'I S. OR ERE-_A'CE'
Please iIII I--aII acdcoar'sne -td--e: p-
Name of Aoniicent : r`.11)aa/f1S Itab-- tA< t-r're IfJC�.
Address: /a6 6/t/c ` ta , In A/c(y nt h aid95 -e__ - _: *3 39'73 k!!
i Owner of Property l Jen �c j
_ l S{recco
Address: f . Hatc/T) r, fJarenec mAoms;-s:__- _. e: zits- 7a7- a3b8
Status of Applicant : Owner x Contractor
4. Type or Brand of Stove :_fie A/JI/A - 712oL 610d;7 S7Ozrc
5. Estimated Cost: o?3 00 tie _
if applicant is not the homeowner::
Contractor name - /Ddo /at LPkbet
Construction Supervisor's_ License Number 5110/ E - e:.cn Date /-4 "/2
Home Improvement Contractor Registration Number 18'(/77 Expiration Date //-/3 V P
Al!Applicants must complete a Workers s Compenselon Insurance Affidavit before we cnn issue a permit
S. Certification:I nearby certify that the information contained herein is true and accurate to the best of my
knonsIedoe.
DATE: 5/3 /7 APPLICANTS SIGMAiUREG��---"'.-.LL--->
DATE: //,,,V// 7 HOMEOWNERS' SIGH IATURG_ /24W-`
.APPROVED ��,
DATE: �2-/12 Bull..DING 0FFICIA
7
The Commonwealth of Massachusetts
Department of Industrial Accidents
{a1'= 1i[ I Congress Street, Suite 100
Boston,MA 02114-2017
yam 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.❑O I am a employer with 10 employees(full and/ 5. ❑Retail
or part-time).* 6. ❑Restaurant/Bar/Eating Establishment
2❑ 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] 8. ❑Non-proft
3.❑ We are a corporation and its officers have exercised 9. ❑ Entertainment
their right of exemption per c. 152,31(4),and we have 10.0 Manufacturing
no employees.[No workers' comp. insurance required]**
11.0 Health Care
4.❑ We are a ion-profit organization.staffed by volunteers,
with no employees. [No workers' comp.insurance req.] 12.❑Other _
'Am applicant thm checks ho',I corm also 1111 out 0e section below shoring their trorkers'compensation policy information.
""If the corporate officers duce exempted themsel cgs hut corporation has other employees.a workers compensation policy Ls required and such an
nraarimation should check boy 41.
I am an employer that is providing worked 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
City/State/Zip: BRAINTREE, MA 02185
Policy d or Self-ins. Lie.L 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 ofa
fine up to S 1.500.00 and'or one-year imprisonment.as well as civil penalties in the form ofa STOP WORK ORDER and a fine
of up to$250.00 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 cern under the pains an nal ties of perjury that the information provided above is true and correct.
Signature: 2 'Cae Date: $57 /3 /.7
Phonea.. yls sqq!- 3y 2
Official use only. Do not write in this area.to be completed by city 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#:
wn\r mass.goy/dia
Ember Protection
The stove may be installed on a combustible floor, provided ember protection made from a non-combustible
material (a minimum K value of 23.7 btu/ft h ' F/the equivelent of 20 Gauge steel) is used.
UL 1618 type 1 protection
This protection must extend as follows:
In Canada 18" (457 mm)from the loading door on the firing side and 8" (203 mm) from the sides. See Figure
3. below.
In USA: 16 (406 mm) to the front of the firebox and 8" (203 mm) from the sides of the fuel loading door
opening. See Figure 4. below. This protection is also required under the chimney connector and 2" (51 mm)
beyond each side.
Canada Only //tA
United States Only
Minimum width:37 3de 1949 mm) Minimum width:28 3:4"(730 mm)
Minimum overall depth:49 3/4"11.26 m) Minimum overall depth:39 3(4'(1.01 m)
8" [203 mml ® �'
Non-combustible Non-combustible
SSIMISSESE
ember protector ember protector
N
to
rn
op;
wcv
jam- E
3 £
18" [457 mm] 16" [406 mml on
Figure 3' Floor protector Canada. Figure 4: Floor protector United States.
Securing Bracket Installation:
These will be needed to anchor the stove in a
mobile home instalation and are recomended when
installing combustion air to prevent movement
of the unit and seperation of the combustion air
intake.
1. The hold down backets are provided in a bag e
with the unit. Insert the brackets by sliding
them through the slots in the rear legs. Then lag
the bracket to the floor or hearth pad.
Figure 5: Securing bracket.
TN20 270015 23 13 5055.552-A ..... ".."
Double-Wall Connector
• Use a listed double-wall connector.
• Install all components to the chimney connector manufacturer's installation requirements,
Single-Wall Connector
Smoke pipe (chimney connector) must be:
• As short and straight as possible. use 6"(150mm) diameter, minimum 24 gauge black pipe, that is clean
and in new condition.
• Secured at every joint and collar with 3 sheet metal screws.
• Installed with the crimped or male ends pointing down. This will carry any liquid creosote or condensation
back into the stove.
• The Smoke pipe/chimney connector shall not pass through an attic, roof space, closet or similar
concealed space. or a floor. or ceiling. Where passage through a wall, or partition of combustible material
is desired. the installation shall conform to CAN/CSA-6365, INSTALLATION CODE FOR SOLID-FUEL-
BURNING APPLIANCES AND EQUIPMENT or NFPA 211 STANDARD FOR CHIMNEYS, FIREPLACES AND
SOLID FUEL BURNING APPLIANCES
Procedure
1. Position stove and floor protection (with hole for combustion air if required) in accordance with the
clearances as stated on the label and in Figure 7 on page 16.
2. Mark the position for the hole in the ceiling and roof by using a string and plumb-bob,
3. Check that the intended location will not interfere with floor joists, ceiling joists or rafters before
proceeding further.
4. As per the chimney manufacturer's instructions:
• Cut a hole in the ceiling and roof to suit the chimney system and frame in the sides. The chimney
support is mounted to the framing. If a roof or ceiling support is used in the installation, you will find the
chimney manufacturer's complete instructions packed with the roof support.
• Assemble the chimney sections so the finished length is resting on the support and protruding through
the roof. Install the radiation shield.Avoid having chimney joints between ceiling and roof,
• Assemble flashing and storm collar and be sure to secure the flashing and seal with the appropiate
sealant, Attach rain cap and check flashing for leaks.
5 If double-wall connector pipe is to be connected between the stove and the listed insulated chimney,
install all components to the pipe manufacturer's installation requirements. (
6. If smoke pipe is being used to connect between the stove and the listed insulated chimney,
• Install the smoke pipe (chimney connector), crimped edge of the pipe down and inside the stove collar.
Use holes provided in collar to secure pipe with three screws.
• Install the remaining lengths of pipe. one on top of the other to the finished height of the listed insulated
chimney adapter and secure to each other. A slip-section will make attaching the smoke pipe to the
chimney sytem adapter easier.
14 TN20 270916-28