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24A-115 BP-2022-0372 6 CALVIN TERR COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 24A-I 15-001 CITY OF NORTHAMPTON Permit: Alts Renovations Repair PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2022-0372 PERMISSION IS HEREBY GRANTED TO: Project# INSTALL WOOD FIREPLACE Contractor: License: Est. Cost: 7904 CORY MCGILL 107658 Const.Class: Exp.Date:05/25/2023 Use Group: Owner: KATHERINE RAY-MENDOZA, JESSICA& Lot Size (sq.ft.) Zoning: URA Applicant: DONE RIGHT CHIMNEY Applicant Address Phone: Insurance: PO BOX 1054 (413)340-1399 WCV01525600 WILLIAMSBURG, MA 01096 ISSUED ON:04/12/2022 TO PERFORM THE FOLLO WING WORK: INSTALL WOOD FIREPLACE 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: Gas: Final: Final: Rough Frame: Rough: Fire Department Driveway Final: Fireplace/Chimney: Final: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: - � Fees Paid: $65.00 212 Main Street, Phone(413) 587-1240,Fax:(413)587-1272 Office of the Building Commissioner li Ey:5- , The Commonwealth of Massachusetts/ APR tia 1 1 2 FOR Board of Building Regulations and Standards Massachusetts State Building Code 780 C.i MUNICIPALITY � ��'•`• � - USE Building Permit Application To Construct,Repair,Renbvati Or#e;4 o -• Revised Mar 2011 One-or Two-Family Dwelling -`.�' oio;;4;'''�'' This Section For Official Use Only Building ermit Number: .6(2-' ) 7---j?y Date Applied: L'U 1iJ �o --- L LI-1I Z0z2 Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 6 Calvin Terrace c-f fit If 1.1a Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) _ Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 0 Private CI Municipal_ Outside Flood Zone? Municipal 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSLUP1 2.1 Owner'of Record: Jessica Ray-Mendoza Northampton, MA 01060 Name(Print) City,State,ZIP 6 Calvin Terrace (206)601-1860 jessicamndza@gmail.com No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition 0 Accessory B 'Bldg.0 Number of Units Other l Specify: Chimney reline a wood insert install Brief Description of Proposed Work2: To install a Regency Cascades i1500 wood fireplace insert into existing masonry fireplace.To line existing masonry chimney with a 6"I.D.round stainless steel liner and connect to wood insert,after completing an NFPA 211 Level 2 inspection. SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building 5 7,904.44 1. Building Permit Fee: S Indicate how fee is determined: ❑Standard City/Town Application Fee 2.Electrical S ❑Total Project Costa(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: S 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire $ Suppression) Total All Fe>>es:S Check No./)l I Check Amount: Cash Amount: 6.Total Project Cost: $ 7,904.44 ❑Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CS-107568 05/25/2023 Cory McGill License Number Expiration Date Name of CSL Holder List CSL Type(see below) U P.O. Box 1054 No.and Street Type Description Williamsbur , Ma 01096 U Unrestricted(Buildings up to 35,000 cu.ft.) g R Restricted I&2 Family Dwelling City/Town.State,ZIP M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances 413-340-1399 Donerightchimneyservices©gmail.com I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) 178722 08/27/2022 Cory McGill HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name P.O. Box 1054 Donerightchimneyservices@gmail.com No.and Street Email address Williamsburg, Ma 01096 413-340-1399 City/Town,State,ZIP Telephone SECTION 6:WORKERS' COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152.§ 25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the Issuance of the building permit. Signed Affidavit Attached? Yes X No l7 SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize Cory McGill to act on my behalf,in all matters relative to work authorized by this building permit application. 3e.,,,e-7;cc,12_,A.1/4 &vats 9/0/202-2- P Owne s me(El G is Signature) l Date SEECTION 7b:OWNER' OR AUTHORIZED AGENT DECLARATION By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this application is true and accurate to the best of my knowledge and understanding. Cory McGill I��b/ � Print Owner's or Authorized A en' : ame(Electronic Date NOTES: 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program can be found at www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.nov/dps 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch) Gross living area(sq.ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" City of Northampton 212 Main Street, Northampton, MA 01060 Solid Waste Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c 111 , S 150A. Address of the work: 6 Calvin Terrace The debris will be transported by: Done Right Chimney The debris will be received by: Valley Recycling 234 Easthampton Road, Northampton, MA 01060 Building permit number: Name of Permit Applicant Cory McGill LiA Date Signature of Permit Applicant The Commonwealth of Massachusetts �� Department of Industrial Accidents 1 Congress Street,Suite 100 Boston,MA 02114-2017 t,- www.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PER:YIITTING AUTHORITY. Applicant Information Please Print Legibly Name(Business/Organization/Individual): Done Right Chimney Address: P.O. Box 1054, 45 Main Street, Unit B city/stateizip:Williamsburg, Ma 01096 Phone#:413-340-1399 Are you an employer?Check the appropriate box: Type of project(required): 1.E I am a employer with 3 employees(full and/or part-time).' 7. El New construction 2 I am a sole proprietor or partnership and have no employees working for me in any capacity.[No workers'comp.insurance required.) S. Remodeling 9. ❑Demolition 3.❑I am a homeowner doing all work myself.(No workers'comp.insurance required.] 10 []Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.0 Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5,0 1 am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13. Roof repairs These sub-contractors have employees and have workers'comp.insurance.t 6.0 We are a corporation and its officers have exercised their right of exemption per MGL a 14. Other Chimney Re Lining 152,§1(4),and we have no employees.(No workers'comp.insurance required.) &wood insert install *.Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I ant an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Atlantic Charter Insurance Company Policy#or Self-ins.Lie.#: WCV 01525600 Expiration Date: 06/28/2022 Job Site Address: 6 Calvin Terrace City/State/Zip:Northampton, MA 01060 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to $1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP\VORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certi under the pains and penalties of perjury that the information provided above ' true and correct. Signature: • /`�// / Date: I/6 Phone#: 4 3-340-1399 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): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: • • INSTALLATION INSTRUCTIONS Phone:888-900-8106 FOR BEST-Flex Models "L", "H", "S", & "E" Fax:888 392 4432 STAINLESS STEEL CHIMNEY LINERS Web:www.NewhnglandChimney5uppiy.com 34 Commerce Street,Williston VT 05495 I•111116 BEST-Flex Models 1_777 6611777 66S77 & 66E11 BEST FLEX New England Supply STAINLESS STEEL CHIMNEY LINERSG PRODUCTS BEST-Flex Models"L","H","S &"E"Stainless Steel Chimney Liners are manufactured by New England Supply Inc.Located in Williston,VT. The BEST-Flex lining system is designed and UL listed to be installed inside masonry chimneys.BEST-Flex liners are used to vent the gases and by-products produced by appliances that burn oil,gas,or solid fuels. All appliances require certain venting specifications and the liner is not to be sized less than specified in the appliance manufacturer's instructions.For the best operation refer to the appliance manufacturer's instructions to determine any special necessities for that specific appliance. The installer must contact the local building and fire code officials for a variety of reasons: • The installation may require special inspection requirements. • Building permits may be required before installation. • Compliance with local building codes.(Authorities with local jurisdiction such as Inspectors.Municiple Building Departments.Fire Departments,and Fire Bureau's have precedence over national codes). For proper results and operation use only materials or components specified in these installation instructions. Using parts or materials not specified may result in undesireable effects. The lining system safety,code compliance.warranty and performance may be compromised if the installation instructions are not followed BEST-Flex Stainless Steel Chimney Liners are tested and listed by Underwriters Laboratories. • In the United States they are tested to UL 1777 and can be installed in NEW&EXISTING masonry chimneys. • In Canada they are tested to ULC S635 and are to be installed in EXISTING masonry chimneys. PRODUCT INFORMATION FOR BEST-Flex CHIMNEY LINERS • The BEST-Flex Stainless Steel Flexible Chimney liner is designed to reline existing chimneys or to be used as a liner in new construction. Manufactured with the highest quality,mill certified alloy.BEST-Flex Stainless Steel Flexible Chimney Liner has a high acid fighting capability. Listed by UL Laboratories to UL 1777&ULC S635 standards for zero clearance installation.BEST-Flex can be used to vent wood,wood pellet,coal,non- condensing gas and oil,making it the choice for venting all standard efficiency installations.UL listed BEST-Flex is available in 3"to 12"diameters (13"above is not listed)to cover a wide range of requirements found in the field today. • The unique manufacturing systems used to make BEST-Flex utilizes a continuous strip of stainless steel,7-ply interlocked and crimped to produce a gas and water tight lining system of superior strength and durability.BEST-Flex can be curved to go around offsets in chimneys and can be factory ovalized to custom sizes to fit most any installation requirement.Unless specified by the manufacturer,the liner is not to be field ovalized. The corrugated construction allows for expansion&contraction during the heat-up&cool-down periods.which removes any stresses on the system. • BEST-Flex can be insulated with either a vermiculite based poured insulation or with a foil-faced ceramic wool blanket to meet UL 1777&ULC S635 standards for chimney exteriors with zero clearance to combustibles. • BEST-Flex Stainless Steel Chimney Liner comes with a Life Time Warranty for all fuels,with appliance efficiencies at 83 percent or lower. MATERIALS REQUIRED FOR BEST-Flex STAINLESS STEEL LINER INSTALLATION: Liner Model-"L","H", "S", &"E" TT I TB-Two piece or one piece tee TEC-Tee Cap EA/EF- 15°-90°elbow C/CC-Coupler _� Screws/Rivets OPTION A ' OPTION B TP-Top Plate ° R TPCC-Liner Cap TC-Top Clamp a TPC-Top Plate SC-Storm Collar Q"; »� ;+r � OR OR CL-Liner Cap(square/round) '`�'� �' yt INSULATION MATERIALS REQUIRED(if applicable) Part# Description LI2 Liner Insulation 1/2"Foil Faced Ceramic Wool Blanket LM Liner Mesh Protective Wire Mesh Sleeve FT(2", 3") Aluminum Foil Tape LMC(large/small) Mesh Clamp - BMIX BEST Mix ,mu,ua, pnn,aw,a,wa,