17A-001 (4) 220 SPRING GROVE AVE BP-2019-0203
GIS#: COMMONWEALTH OF MASSACHUSETTS
MaR.Block: 17A-001 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit. Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Cateeorv: woodstove BUILDING PERMIT
Permit BP-2019-0203
Project JS-2019-000334
Est.Cost: $3200.00
Fee: $40.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: THE FIRE PLACE 99401
Lot Size(sa.ft.): 13503.60 Owner: FRITZ NICOLE
Zoning,RI(I00)/URA(t00VWSP(I0o)/ Applicant: THE FIRE PLACE
AT. 220 SPRING GROVE AVE
Applicant Address: Phone: Insurance:
P O BOX 606 (413)397-3463 0 WC
WHATELYMA01093 ISSUED OM8/17/2018 0.00:00
TO PERFORM THE FOLLOWING WORK.ENVIRO - VENICE WOOD INSERT
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:
FeeTvoe: Date Paid: Amount:
Building 8/17/2018 0:00:00 $40.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
City of Northampton
Massachusetts
R
}$ 5 DEPARTMENT OF BUILDING INSPECTIONS
zlz Main street . Municipal aa,la,as
Northampton, MA 01060
RE ED ,o I
auc s 2018 r6p-19 —aU �)
Dear of aor DIN,, Mnot51016LE R TWO FAMILY SOLID FUEL APPLIANCE PERMIT APPLICATION
NORTHAMPTON.
ow
FOR WOOD,COAL, PELLET,CORN,STRAW 3yy ES
LAR STOVES.OR FIREPLACES
Check
Please fill in((all appropriate informations
t. Name of Applicant _7)OUyL4r 1 )960[c — -7AC la /�qCC
Address: ._/6L 15`" (R1i`/d�t-Cy 91tA o1G93 Telephone: 1Ii3 39�•35CL�`
2. Owner of Property /V ied< 6'i 1"p �
Address. Jot' 67 Sri/� �/VVe A `C r1.I'eAK Telephone: 97/-1?o9-7-?VV /
3. Statusof Applicant Owner Contractor
4. Type or Brand of Stave:__ 6nY!Po _ VCMGe (,rVao %ASTI,4
5. UL Listing OU.'�Pa
6. Estimated Cost
7. Email
If applicant is not the homeowner:'y�
Contractor name G h L PAI Email : 6C1 iffil
Construction Supervisors License Number Y%yel Expiration Date
Home Improvement Contractor Registration Number Expiration Date PYP
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 8''/�iP APPLICANTS SIGNATURE
DATE'. =f�' HOMEOWNERS SIGNATURE
APPROVEDtom _ __/
DATE L//�/ / t-(}__ BUILDING OFFICI
_ - ....___
The Commonwealth of Massachusetts
Department oflndushialAecidents
Iriu n_
Z Congress Street,Suite 100
—_-_ Boston, AM 021142017
www-nrassgov/dia
Workers'Compensation Insurance Affidavit:General Businesses.
TO BE FILED WITH THE PERMITTING AUTHORITY.
Applicant Information Please Print Ledb)v
Business(Oranizadon Name:THE FIRE PLACE
Addresa:106 STATE RD- P.O.BOX 606
CiR•;Siate%Zip:1NHATELY,MA 01093 phone#:413-397-3463
j Are .on an employer?Check the appropriate box: Business Type(required):
i.❑✓ !am a employer with 10 employees(M and/ 5. Retail
or par.-time).` 6. ❑Restaurant/BaslEating Establishment
=.❑ l ant a sole proprietor or partnership and have no
7. ❑Office and/or Sales(incl.real estate,auto,etc.)
empiouxes working For me in any capacity.
[No workers'comp.insurance required] 8- ❑Non-profit
Z❑ Wo arc a corporation and its officers have exercised 9. ❑Entertainment
:heir right of exemption per c. 152,§1(4),and we have 10.❑Manufacturing
no employees.[No workers'comp.insurance required]'
Q
we are a non-profit organization,staffed by volunteers, I I.[]Health Cate
with no employees.[No workets'comp.insurance ny.] 12.❑Other
I,%,applicam uat checks box'A1 mart aka fill out theseation below slowing Iheirwoikers compauaaw policy infotmadon.
-irthec gomtc oftices lave exempted oiem dv ,hurtle mryontion has oUeramplo .a waslau compeasawn policy is required and such as
organwadanshaaldcaeckbax:1.
I am an employer that isproviding worker,'compansashm insurancefor my employees Below is the policy Information.
hiss mence Company Name:MA RETAIL MERCHANTS WC GROUP INC
Insurer's Address:P-0.BOX 859222-9222
Cit,,/State/Zip: BRAINTREE MA 02185
Pohcv#or Self-ins.Lia#0140050336011116 Expiration Dain.
Attach a copy of the workers'compensation polity declaration page(showing the policy number and expiration date).
Failure to secure coverage as required order Section 75A of MGL c 152 can lead to the imposition of criminal penalties of
tine up to S 1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine
crop to 5250.00 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 ceerei,�un/der the pains and sess ofperjury that the informadon provided above is one and correct
S m . %-e-a�-' alk Date- �, ve'ov )o
Phone 7:413397-3463
Official use only. Do not write in this area,to be completed by city or town official.
City or Towo: - PermiNLicense#
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.City)Town Clerk 4.Licensing Board 5.Selectmen's Office
6.Other
Contact Person: Phone#:
www. �ovidia
SPECIFICATIONS
CLEARANCES To COMBUSTIBLES - 1200-V INSERT:
Table 2: 1200-V Insert Clearance to Combustibles.
A Minimum clearance to an unshielded side wall 10" (254 mm)
B Minimum clearance to an unshielded 8" (203 21"(533 mm)
mm) mantel
C Minimum top facing (protruding 3A" [19 mm])
1716"(445 mm) ; B
clearance
c
D Minimum side facing (protruding '/n" [19 mm]) 1" (25 mm) _D-
clearance 'a A
E ' From front of door opening to edge of Floor USA 16" (406 mm)
protection CND 18"(450 mm)
F ` From side/back of unit to edge of Floor USA 6" (152 mm) F
protection CND 8" (200 mm)
t FLOOR PROTECTION:
If unit is raised 0" -2" (Omni-51mni 1" (25mm) non-combustible material with k value = 0.84 or equivalent.
If unit is raised 2"-8" (51mm-203mm); 1/2" (13mm) non-combustible material with k value = 0.84 or equivalent.
If unit is raised greater than 8" (203 mm) or more; any non-combustible material can be used.
Table 3: Reduction in (6) Minimum Clearance from 1200-V to 8"(203 mm) Mantel.
Type of protection Modified Clearance
A minimum of .013" (0.33mm) sheet metal spaced out 1" (25mm) by non- 101/2" (267 mm)
combustible spacers.
Ceramic tiles, or eglvalent non-combustible material on non-combustible 14" (357 mm)
supports and spaced out 1" (25mm) by non-combustible spacers.
Ceramic tiles, or egivalent non-combustible material on non-combustible
supports with a minimum of .013" (0.33mm) sheet metal spaced out 1" 101b" (267 mm)
(25mm) by non-combustible spacers.
NOTES:
(1) Mantel protection must have at least 3"(75mm)edge clearance on all sides, except as provided in Note 4.
f2) If an adhesive is used tc support non-combustible material, it shall not lose adhesive qualities at temperatures
likely to be encountered and shall not contribute a significant combustible load.
(3) Heat shield mounting hardware attached to combustible materials must be placed at the lateral extremities of
the shield.
(4) Minimum clearance to unprotected walls and ceilings must be maintained.
Table 4: 1200-V Insert Minimum Fireplace Size.
Masonry Zero Clearance
Minimum Depth 13'/z" (343 mm) 14" (279 mm)
Minimum Width at back of fireplace 223/3" (568 mm) 23" (584 mm)
Minimum Width at front of fireplace 27"(686 mm) 271/4" (692 mm)
Minimum Width at front of fireplace to include shroud 333/4" (857 mm) 34" (864 mm)
19'/4" (489 mm)" 508 mm
Minimum Height or 193/4" (502 mm) ZO" ( )
** If the masonry lintel height is only 191/4"(489 mm) to 193/4" (502 mm) refer to 1%sTuunoN - Ma,n:r4Tioms Foo
HN U[I I ION vum 191/4" (489 .v) H:oH LINTEL- INSERT
12
INSTALLATION
MASONRY FIREPLACE INSTALLATION:
Unless you are experienced, we recommend installation by your dealer or a
professional installer.
Install only in a masonry fireplace with a good-condition chimney at least 15 IF (4.6 m) high, both of
which have been constructed in accordance with the building code. Refer to Tables 4 and 7 for minimum
masonry fireplace dimensions. Be sure the fireplace and chimney are clean and sound without any cracks
or loose mortar. Do not remove any bricks or mortar from the fireplace.
If there is a combustible Floor In front of the
/— _Rain Cap masonry fireplace, the fireplace insert must
'Z steel Place or Flaming be 8" (203 mm) above the combustible
Floor, and floor protection must be provided
18"(457 mm) in front of the fireplace insert
and 8" (203 mm) to each side of the unit.
-�- Flexible or Rigid 61' Refer also to SFFCIFI01rION5 - CIEARANCEs To
_ Stainless Steel Liner CO%NUs airs-1200V 1'61,Ki and SPCIF[cnncus
- CLEARANCES To Co4eUSTIELEs - 1700-V INs6nr.
1. Remove any fireplace damper or fasten
'�. in a permanent open position.
2. (IN CANADA) The stove is vented with
a 6"stainless steel liner that goes directly to
the top of the chimney and is covered with
r Mantel a rain cap. The chimney top is sealed with
'- } -- - -- a Flashing or steel plate that supports the
weight of the chimney liner. The installation
Top Facing must conform to the liner's manufacturer's
_ \ instructions.
Damper Removed
1 - - or Fastened Open This fireplace must be installed with a
Surround Panel continuous liner of 6" diameter (CANADA
ONLY)extending from the fireplace insert to
Sheet Metal Screws the top of the chimney. The chimney liner
- - Fastening Collar to
Stainless Steel Liner must conform to the class 3 requirements of
-
ULC-5635 Standard for Lining Systems for
Existing Masonry or Factory-Built Chimneys
_ and Vents, or ULC-5640 Standard for Lining
- l Systems for New Masonry Chimneys.
USA 16"((406 mm)
z ' clvo l6•'taso mm) (IN U.S.A.)The appliance when installed,
must follow local building codes, in the
! r'4, --- - - e ti 6" absence of local building codes, with the
Prate tion (203 mm) 9
current NFPA 211 Standard for Chimneys,
Masonry Fireplace - Combustible Floor Fireplaces, Vents, and SOid Fuel-Burning
Figure 11: Insert Installation into existing fireplace with Appliances,
hearth.
17