16D-030 (3) 64 LILLY ST BP-2019-1426
GIS 4: COMMONWEALTH OF MASSACHUSETTS
Map.Block: 1613-030 CITY OF NORTHAMPTON
Lot - 1 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL 042A)
Categom woodstove BUILDING PERMIT
Permit# BP-2019-1426
Project# JS-2019-002308
Est.Cost:$4500.00
Fee:$40.00 PERMISSION IS HEREBY GRANTED TO:
const Class, Contractor: License.
Use Group: THE FIRE PLACE 99401
Lot Size(sa.R.): 14418.36 Owner: MILLS ALETA
Zoning:URB(79)/URA(21)[WP(19V Applicant: THE FIRE PLACE
AT: 64 LILLY ST
Applicant Address: Phone: Insurance:
P O BOX 606 (413) 397-3463 O WC
WHATELYMA01093 ISSUED ON.•6117/2019 0:00:00
TO PERFORM THE FOLLOWING WORK:PACIFIC ENERGY 74 ALDERLA
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 OccuoancY Signature:
FeeTYpe: Date Paid: Amount:
Building 6/17/20190:00:00 $40.00
212 Main Street, Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
64 LILLY ST BP-2019-1426
GIs 4: COMMONWEALTH OF MASSACHUSETTS
Mao-BI k: 16D-030 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-2019-1426
Pro ject# JS-2019-002308
Est.Cost:$4500.00
Fee:$40.00 PERMISSIONIS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: THE FIRE PLACE 99401
Lot Size(su.R.): 14418.36 Owner. MILLS ALETA
zoning:URB(79)/URA(21VWP(19V Applicant. THE FIRE PLACE
AT. 64 LILLY ST
Applicant Address: Phone: Insurance:
P O BOX 606 (413) 397-3463 O WC
WHATELYMA01093 ISSUED ON:6/17/2019 0.00.00
TO PERFORM THE FOLLOWING WORK:PACIFIC ENERGY 74 ALDERLA
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 Sienature:
FeeTvpe: Date Paid: Amount:
Building 6/1720190:00:00 $40.00
212 Main Street, Phone(413)587-1240, Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
City of Northampton
J Massachusetts
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SINGLE OR TWO FAMILY SOLID FUEL A PLiANCE PERMIT APPLICATION
FOR WOOD"COAL,PELLET.CORM,$TaAti,'Cz$:£:LAR$TC4c$.OR FIREPLACES
7 a
I. Name Of.Applicant: /JOU914S Zc - //1C /-/2 �,ee
Address: 14 Allekl AP.4 -_a_____.
2. Owner ofProperty : 191.1C m%//T 4e/•3- a70':31/63
Address: 6>< G•/%, off /a/>•/�c. ddluq _-.-a: SO3•• .4Y�'•GSa3
3. Status of Applicant:_Owner Contracmr
3. Type or Brand of Stove : '[cd'+C Z�r
S. Estimated Cost: rJW . O
if applicant is not the homeowner:
Contractorname eug�LS �•/} <
Construction Supervisors License Number. 9 rye/ cxpi:n6cn Date /-6-a0
Roma Improvement Contractor Registration Number /80Y7? Expiration Date -/p•oO0
All Applicants must complete a Workers Compensation Insurance Affidavit before we can issue a perink
6. Certification:I hearby certify that the information contained herein is true and accurate to the best of my
knowledoe.
DATE: G•y 19 APPLJCANTSSIGNA
DATE:-4-4-11 J�'HOIMEOWNERS SIGNATURE
APPROVED
DATE: BUILDING OFFICIAL RECEIVE D
JUN 1 4 2019
DEPT OF BUUMO INSRECno"S
NORTHAMPTON.MA CW80
' The Commonwealth of Massachusetts
9 02/ DepartmentoflndustrialAccidents
I Congress Street,Suite 100
`- Boston,MA 01114-2017
www massgov/dia
Workers'Compensation Insurance Affidavit:General Businesses.
TO BE FILED WITH THE PERMITTING AUTHORITY.
Applicant Information Please Print Leeib]
Business/Organization Name:THE FIRE PLACE
Address:106 STATE RD-P.O.BOX 606
City/State/Zip:WHATELY, MA 01093 Phone#:413397-3463
Are you an employer?Cheek the appropriate box: Business Type(required):
1.❑" I am a employer with 10 employees(full and/ 5. ❑Remil
orpart-time).' 6. ❑Restaurant/Bm/Eating Establishment
2.❑ I am a sole proprietor or partnership and have no 7 E]Office and/or Sales(incl.mal estate,auto,etc.)
employees working for me in any capacity.
[No workers'comp.insurance required) 8- ❑Non-profit
3.❑ We are a corporation and its officers have exercised 9. ❑Entertainment
their right of exemption per c. 152,$1(4),and we have 10.❑Manufacturing
no employees.[No workers'comp.insurance required]'
4.❑ We arc a non-profit organization,staffed by volunteers, 11.❑Health Care .
with no employees.[No workers'comp.insurance req.) 12.❑Other
'Anyapplicantlhm teaksboxkl martalsofill ora0ase m bebwshowingti6r.vortms'commnfinn policy information.
-slfdr cwpo.avflfi.is have exempted rhemseheR bar the corporation bu orM1eremployees,a Workers wmpenm m polity is rtgoiwd end suchen
o batimshouldcheckbox#l.
I ant an employer that is providing workers'compensation insurance for my employees. Below is rhe policy infarmaHom
Insurance Company Name:MA RETAIL MERCHANTS WC GROUP INC
Insurer's Address:P.O.BOX 859222-9222
City/SmtelZip: BRAINTREE MA 02185
Policy#or Self-ins.Lie.#0140050336011116 Expiration Date.
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required trader Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of
fine 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
ofup in 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 cerdfy,u er thepain,s/pandparr es o'fperjuty that the infornratianprovidedabove is
owe audcorrect
Signature: K/ a�P-'^ Date: lv• s'fj
Phone#:413-397-3463
Ojrcial use only. Do not write in this area,to be completed by city or town oofelat
City or Town: Permit/License#
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.mass.gov/die
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 Unit
NFI woodburning Specialists or who are certified in Canada by Wood Energy to a chimney flue serving
Technical Training(WETT).
another appliance.
• 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 5-641 LISTED CONNECTOR AND ULC-5-629 LISTED CHIMNEY,IN USA
- UL-103 HT LISTED CONNECTOR AND CHIMNEY
Clearances — Residential
1. This heatermaybe installed usmga single-wall connector(smoke pipe)orlisteddouble-
wall connector(see Mobile Home installation).
2. Clearances to combustible surfaces and materials using single-wall connector are 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.
Minimum Clearances to Combustibles — Residential
15 10"
20.75" 361mm 22.625' 254mm
527ff575mm
SINGLE WALL Vvs�,6.4
manCONNECTOR �Q10"26254mm6omm
Damm
12.75 12.75 16.]5" 1 15.625"_ 3'
324mm '324mm 426mm 2]9mm 39]m ]bmm
C; Q 3052mm a
DOUBLE WALL 12' Q
CONNECTOR 24^ 305mm / 3-�
610mm 24. ]6mm
61pmm
ALCOVE: MIn.Height 71/2feel(2.29m)
Max.Depth 4 feet(1.22m)
080515-24 ALTO —7 ®PACIFIC ENERGY FIREPLACE AE
PRODUCTS LTD.
Floor
The stove may be installed on a combustible
Canada Only floor provided noncombustible ember protea U.S.A. Only
Minimum Width -40"(1.02.) tion is used. Minimum Width -32"(813m)
Minimum Overall Depth-431/4"(1.1m) This protection must extend as follows: Minimum Overall Depth-331/4'(845m)
In Canada: 18"(457 mm)on the firing side
and 8" (203 mm) to the other sides. See
Figure 05 on left.
B" [203mm]
In USA: 16" (406 mm) to the front and S'
®a _ (203 to the sides the fuel loading
opening.
E door opening. See Figure •fi on right. ®a
This protection is also required under the
`. chimney connector and 2' (51 mm)beyond
each side.
o E
18" [457mm] 3 `"
3 3 16[406mm)
Noncombustible floor protector Noncombu,ihble floor protector
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-8365, Installation Code for Solid-Fuel-euming 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%1001 diameter hole
directly below the bottom hole of the ash box enclosure(see page 6,Fig.#Is).Connect
enclosure to the floor with a short 4'(100mm)diameter pipe.
This hole must get its air from a ventilated crawl space or be extended with duct to the
outdoors (see Figure 84, 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 mom 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.
®PACIFIC ENERGY FIREPLACE 12 080515-24 ALT4
PRODUCTS LTD.
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Selkirk Chimney Systems (USA Only-See separate Instructions(o.Canada)
riition instructions
Covering-General Instal lation Instructions
A MAJOR CAUSE OF CHIMNEY-RELATED FIRES 15 FAILURE TO MAINTAIN REQUIRED
CLEARANCES (AIR SPACES) TO COMBUSTIBLE MATERIALS. IT IS OF THE UTMOST
IMPORTANCE THAT THIS CHIMNEY BE IN. WgRNING
STALLED ONLY IN ACCORDANCE WITH
THESE INSTRUCTIONS.
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