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35-161 (5) 785 RYAN RD BP-2021-1042 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 35- 161 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-2021-1042 Project# JS-2021-001777 Est.Cost: Fee: $40.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: THE FIRE PLACE 99401 Lot Size(sq. ft.): 37374.48 Owner: FRIEDMAN HARVEY Zoning: Applicant: THE FIRE PLACE AT: 785 RYAN RD Applicant Address: Phone: Insurance: P 0 BOX 606 (413) 397-3463 O WC W HATE LYMA01093 ISSUED ON:3/23/2021 0:00:00 TO PERFORM THE FOLLOWING WORK:WOOD STOVE - BASEMENT 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 N I 'TH• PTO UP IOLATION OF ANY OF ITS RULES AND REGULATIONS. I I i • j Certificate of Occupancy Signature: FeeType: Date Paid: Amount: Building 3/23/2021 0:00:00 $40.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner City of Northampton '''-_,,Vie,,, p aver > w `/ t .."* _ T / I f).-' Jd .�� ; Massachusetts // �/� ��/�' w' ,.Gfi t. j4.( „i�' }` DEPARTMENT OF BUILDING INSPECTIONS �� � • 212 Main Street • Municipal Building 40(9, „ " a r\ ups' Northampton, MA 01060 /4liiii. 'rsy. -; 11a' / `~'�)N /AiS,o I(/ ! �� F(=T APPLICATION FOR SOLID FUEL APPLIANCE INSTALLATION Property Information Owners Name: I/efr Vc y �;-I/no n Address: r S /ey00 `1f� 1/ale hCc 4 l/od (No.) (Street Address) Phone: /i-3 c /a .3."s1 a Cell: Email: Owners Signature: ;✓ ,u/ i Date: �/aa/2l Contractor's Information (If Applicable) Name: D avy/tS z •Ah1�- Phone: '3 ,.37 3s(43 Construction Supervisor's License #: ,7?f s/(1/ Expiration: /-C -a4:L Home Impr. Contractor License #: /105/77 Expiration: i/-/,, .,)a Stove Information —��52 / I n-43 max/S1:n7 /"sor,r'y �if;rx/?ley et)/ 55 ,vfkx /%rk/' Type of Fuel (check all that apply): Wood X Pellet Coal Location: '&56-men Freestanding )C• Insert Manufacturer: '<- i hr/h Model: 2/ o 7 FOR BUILDING DEPARTMENT USE ONLY--------_-__--..-_--___---- Permit#1 /',O/1 Date Applied: Total all Fees: $ l U C/6#/?73/ Building Official: / v 1 is Z5 Date Issued: 33-2 3-2021 (Prim-)Zp Signature of Building Official: The Commonwealth of Massachusetts Department of Industrial Accidents 9 ? Office of Investigations l'+ Lafayette City Center 2 Avenue de Lafayette, Boston,MA 02111-1750 1 \= --1 www mass.gov/dia Workers'Compensation Insurance Affidavit: General Businesses Applicant Information Please Print Legibly Business/Organization Name:THE FIRE PLACE Address: 100 STATE RD City/State/Zip:WHATELY, MA 01093 Phone#:413-397-3463 Are you an employer?Check the appropriate box: Business Type(required): I.❑i1 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-profit 3.❑ We are a corporation and its officers have exercised 9. 0 Entertainment their right of exemption per c. 152,§1(4),and we have 10.0 Manufacturing no employees. [No workers' comp. insurance required]** 11 ❑ Health Care 4.❑ We are a non-profit organization,staffed by volunteers, with no employees. [No workers' comp. insurance req.] 12.0 Other *Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. **If the corporate officers have exempted themselves,but the corporation has other employees,a workers'compensation policy is required and such an organization should check box#1. /am an employer that is providing workers'compensation insurance for my employees. Below is the police•information. Insurance Company Name: MA RETAIL MERCHANTS WC GROUP INC Insurer's Address:P.O. BOX 859222-9222 City/State/Zip: BRAINTREE, MA 02185 Policy#or Self-ins. Lic. #01400503301116 Expiration Date: 1-1-22 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under§25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a 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 cerytif/y,,under the pains and p allies of perjury that the information provided above is true and correct. Signature: L!t it.....• Date: /'/ ,:i( Phone#: 3 ,g7, 34 i Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(check one): 1.❑Board of Health 2.0 Building Department 3.0 City/Town Clerk 4.❑Licensing Board 50 Selectmen's Office 6.❑Other Contact Person: Phone#: www.mass.gov/dia Stove Dimensions 28 3/4" 28 3/4" 21 5/8" [730 mm] 21 5/8" ~[730 mm] ~[549 mm] 23 7/8" [549 mm]~ 23 7/8" [606 mm]~ [606 mm] i ! ...—.------, / 281/8' d 261/4" 281/8" 281/8" 261/4"i'l 281/8" [714mm] `, [667mm] • [714mm][714mm]LW 667mm] [714mm] iir- v ��_ ______ , Figure 1: TN2OB Dimensions. Residential Installation Warning: Under no circumstances is this heater to be installed in a makeshift or "temporary" manner. It may be fired only after the following conditions have been met. • DO NOT CONNECT THIS UNIT TO A CHIMNEY FLUE SERVING ANOTHER APPLIANCE. • DO NOT INSTALL IN A SLEEPING ROOM. • THIS ROOM HEATER MUST BE CONNECTED TO: 1. A CHIMNEY LISTED TO: UL 103HT (USA) or ULC-5629 (CANADA) or 2. A CODE APPROVED MASONRY CHIMNEY WITH A LISTED FLUE LINER. • DO NOT ATTEMPT TO CONNECT THIS HEATER TO ANY AIR DISTRIBUTION DUCT. • The services of competent installer are strongly recommended. • Outside combustion air or fresh air into the room may be required in your area, consult local building codes (see Combustion Air section). NATIONAL We recommend that our products be \ FIREPLACE installed and serviced by professionals INSTITUTE NFI who are certified in the U.S.by the 6 National Fireplace Institute(NFI) or in Canada by Wood 0 Energy Technical Wood Energy CERTIFIED Training (WETT) Technical K'+1'r+'wettinc.ca \ www.nficertified.org / • 1 1 061 8-28 TN 20B ©PACIFIC ENERGY FIREPLACE 11 PRODUCTS LTD. Crate Removal 1. Carefully remove wood top and supports. 2. Remove plastic cover. 3. Remove all screws holding the Legs or Pedestal, to the Pallet. Residential Clearances • BOTH CHIMNEY SYSTEM AND CONNECTOR MUST BE 6"(150mm) DIAMETER AND LISTED TO: CANADA- CONNECTOR - LISTED to ULC S-641 and CHIMNEY LISTED to ULC-S-629 USA - CONNECTOR AND CHIMNEY LISTED to UL-103 HT 1. Residential Clearances to Combustible surfaces and materials; This heater may be installed using a single-wall connector(smoke pipe) as per local and National fire and Installation codes. see Single wall Connector in figue 2. Clearances may be reduced with various heat shielding or insulating materials. Consult local and national fire codes and authorities for approval For close clearances, use a listed double-wall connector, See (Figure 2). "Double Wall Connector Mobile Home installation see "Mobile Home Installation"Figure 8 on page 19. Minimum Clearance to Combustibles Single Wall Connector- Residential " // /////%////////i%/, ,.F/i%///, i/ l 18 3/8" 12" j j 8" 467mm 305mm j 19„ �03mm -I i- 12" % j 483mm ® 305mm j /0 22 3/4 j or 1 578mm 203mm Double Wall Connector- Residential i 11 3/8" 5" 11 3/8" 5" 28•mm 127mm 289mm 127mm ifirderiffirffrZer.e/frA /'//// /�%/////7 //4• j%// % /' 14" 3„ g" ____.# % 8„ - 1_ 8" z % 355mm 76mm ;M� 11 203mm203mm 203mm j /�` L. P 4/ 476mm0 % 476mm 4 'mum= L al" 1 , 3., Alcove: Min. Height 7' [2.13m] 76mm Max. Depth 3' [915mm] Figure 2: TN2OB clearances.ai 12 ©PACIFIC ENERGY FIREPLACE TN 208 110618-28 PRODUCTS LTD. Ember Protection The stove may be installed on a combustible floor, provided ember protection (UL 1618 type 1 )made from a non-combustible material (a minimum K value of 23.7 btu/ft h ° F) the equivelent of 20 Gauge steel or tile is used. 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 a horizontal chimney connector and 2" (51 mm) beyond each side of it. Canada Only United States Only Minimum width:37 5/8" (956 mm) Minimum width:28 3/4"(730 mrn) Minimum overall depth:50"(1.27 m) Minimum overall depth:40"(1.016 m) = 8" [203 mm] Non-combustible Non-combustible ember protector floor protector �► CD°3- 7-1---)4 N co O O co (.J N 3 �► __ co I� N co O OM 3 cv 18"[457 mm] 3 16', [406 mm] co Figure 3: TN2OB Floor protector Canada. Figure 4: TN2OB Floor protector U.S.. 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 r' 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. 110618-28 TN 20B ©PACIFIC ENERGY FIREPLACE 13 PRODUCTS LTD.