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23D-061 (11) BP-2022-0737 18 LONSDALE AVE COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 23D-061-001 CITY OF NORTHAMPTON Permit: Solid Fuel Appliance PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2022-073 7 PERMISSIONIS HEREBY GRANTED TO: Project# CHIMNEY LINER Contractor: License: Est. Cost: 4300 CORY J MCGILL 107658 Const.Class: Exp.Date:05/25/2023 MACDONALD CATHERINE M&CHARLOTTE Use Group: Owner: ANN CAPOGNA &J KIM Lot Size (sq.ft.) Zoning: URB Applicant: CORY J MCGILL DBA DONE RIGHT CHIMNEY Applicant Address Phone: Insurance: PO BOX 1054 (413)340-1399 WCV 01525600 WILLIAMSBURG, MA 01096 ISSUED ON:06/21/2022 TO PERFORM THE FOLLOWING WORK: WOOD STOVE INSTALL 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: Final: Final: Final: Rough Frame: Gas: Fire Department Driveway Final: Fireplace/Chimney: Rough: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: I )2 . 51-1 • vr 6 1 Fees Paid: $40.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Buildina Commissioner REC� The Commonwealth of Massacl}usett JUN 2 j Board of Building Regulations and1JStan4.rds 2022 F R It j^ Massachusetts State Building Codeh 7801 at UNI PALITY ^ OF pub SE Building Permit Application To Construct,Repair,R nova .tDi ishgkT,�N.ev�( Mar 2011 One-or Two Family Dwelling 'A°7°so s This Section For Official Use Only Buildin Permit Number: 3 P— t 3-• —13 7 Date Applied: /,v,� 'Z5 ,/�' -ZLZa22 Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numb rs 18 Lonsdale Avenue 1.1 a Is this an accepted street?yes no Map Number 0 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 0 Zone: — Outside Flood Zone? Municipal 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP1 2.1 Owner'of Record: Catherine MacDonald-Amias Northampton, MA 01062 Name(Print) City,State,ZIP 18 Lonsdale Avenue (413) 320-8390 catmacd@gmail.com No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg.0 Number of Units Other d Specify: Wood stove install Brief Description of Proposed Work2:To install a Morso 6143 on a UL listed hearth pad, into a masonry chimney previously relined with a 6" insulated liner and insulated wall wall thimble from chimney through combustible wall. SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ 4300 1. Building Permit Fee:$ Indicate how fee is determined: 2.Electrical $ ❑Standard City/Town Application Fee ❑Total Project Cost3(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire $ Total All Fees:$ Suppression) i� Check No.)l ( Check Amount Cash Amount: 6.Total Project Cost: $ t.j ❑Paid in Full El Outstanding Balance Due: The Commonwealth of Massachusetts 1, Department of Industrial Accidents —_ j 1 Congress Street,Suite 100 _ Boston,MA 02114-2017 d wwry mass.gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information p Please Print Legibly Name (Business/Organization/Individual): Done Right Chimney Address: P.O. Box 1054, 45 Main Street, Unit B cityistateizip:Williamsburg, Ma 01096 Phone#:41 3-340-1399 Are you an employer?Check the appropriate box: Type of project(required): L®I am a employer with 3 employees(full and/or part-time).* 7. 0 New construction 2.0 I am a sole proprietor or partnership and have no employees working for me in 8. ❑ Remodeling any capacity.[No workers'comp.insurance required.] 9. ❑Demolition 3.0 I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10[l Building addition 4.0 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 50 I am a general contractor and I have hired the sub-contractors listed on the attached sheet. These sub-contractors have employees and have workers'comp.insurances 13.❑Roof repairs 6.0 We are a corporation and its officers have exercised their right of exemption per MGL c. 14. Other Wood stove install 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *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 an: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.Lic.#: WCV 01525600 Expiration Date: 06/28/2022 Job Site Address: 18 Lonsdale Avenue City/State/Zip: Northampton, MA 01062 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 WORK 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 certify under the pains and penalties of perjury that the information provided above is true and correct. l Signature:/�-L"�(� Date: 471))/(e))-9, Phone#:t 13-340-1399 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#: 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 P.O. Box 1054 List CSL Type(see below) V No.and Street Type Description Williamsbur , Ma 01096 U Unrestricted(Buildings up to 35,000 cu.ft.) g R Restricted 1&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) Cory McGill 178722 08/27/2022 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 No ❑ 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 w k uthoriz P this ' ng permit application. Catherine MacDonald-Amias Print Owner's Name(Electronic Signature) ate SECTION 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 McGill4fl/Y4/Z44 6/)//9 Print Owner's or Authorized A ent's Name(Electronic Signature) 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.ntass_Rov/oca Information on the Construction Supervisor License can be found at www.mass.eov/dos 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. 18 Lonsdale Avenue Address of the work: Northampton, MA 01062 The debris will be transported by: Done Right Chimney The debris will be received by: Valley Recycling Building permit number: Name of Permit Applicant Cory McGill dba Done Right Chimney 6/1 41733— Date Signature of Permit Applicant • +4 t Alw .e e,aopaMmeM to The Royal Danin Court morso Installation and Operating Instructions Morsø 6100 B For use in North America • 4 a1 410. • r NW _ t,. Save these instructions MORSO JERNSTOBERI A/S . DK 790o NYKOBING MORS E-Mail: info@morsoe.com•Website:www.morsoe.com Optional Accessories A wide range of accessories (such as handling gloves,fireside tools,glass cleaner and heat- proof paint) are available for use with your Morso stove. They help with day-to-day running and maintenance. Contact your Morse) dealer for more information. The Morso 6ioo B series has been certified by PFS TECO..The test standards are ANSI/UL- 1482-2o1i (R2o15)for the United States and ULC S627-oo for Canada. Certified& PF Portland,Oregon Listed By ® USA PFS TECO Report Number: Fto-581 The stove is listed for burning wood only. Do not burn other fuels. U.S. ENVIRONMENTAL PROTECTION AGENCY. Certified to comply with 2020 particulate emission standards using cord wood. Average particulate emission using ASTM E3o53-17 cord wood test method is o.67 g/h Under specific test conditions this heater has been shown to deliver heat at rates ranging from 15,043 to 380o7 Btu/hr. This appliance was determined to have an average higher heating efficiency value of 77% when tested in accordance with CSA B415.1 This wood heater needs periodic inspection and repair for proper operation. It is against federal regulations to operate this wood heater in a manner inconsistent with operating instructions in this manual. NATIONAL We suggest that our woodburning hearth , FIREPLACE products be installed and serviced by INSTITUTE' N NFI professionals who are certified in the U.S. by the National Fireplace Institute® (NFI) as NFI Woodburning Specialists or who are A certified in Canada by d CERTIFIED Wood Energy Technical Wood Technical Tgaining www.nficertified.org Training (WETT). -w. -•<<:"'.Ca f Cast iron Cast iron is a live material.There are no two ovens that are identical. This is partly due to the tolerances of the casting process, partly because the ovens are a work of craftsmanship. Minor unevennesses may also occur in the cast iron surface. 3 1.5 Positioning the stove Distance to walls and lintel When the stove is positioned near combustible materials, observe all current local and na- tional building regulations with regards to clearances. Whatever regulations apply to your area,do not in any case install the stove within 8 inches of combustible materials around the sides or i6 inches above the top of the stove (fireplace installations require greater clear- ances above the stove - see below in the clearance chart).These distances may need to be increased if the materials are sensitive to heat. Note also that wall paper and other decora- tive materials may become detached with the effects of heat and care should be taken to ensure that they do not fall towards the stove in such an event. When the stove is positioned near non-combustible materials, a gap of 4 inches or more is recommended for cleaning purposes and to ensure that heat circulates around the stove and out into the room. If using rear exit,the floor protection must extend beneath the chimney connector and 2-in beyond each side. CLEARANCE REQUIREMENTS STANDARD RESIDENTIAL INSTALLATION SINGLEWALL CONNECTOR USA CANADA A. Sidewall to unit 10" 254 mm B. Backwall to unit 3" 76 mm C. Cornerwall to unit 5" 127 mm D. Sidewall to connector 15.5" 394 mm E. Backwall to connector 7.5" igo mm F. Cornerwall to connector io" 2S4 mm G. Unit to ceiling 54.5" 1384 mm H. Floor to ceiling 84" 2134 mm MINIMUM CLEARANCES TO COMBUSTIBLES: BACKWALL ADJACENT WALL JFla" 45° ac�w sr • `cn I C r— CLEARANCE REQUIREMENTS STANDARD RESIDENTIAL INSTALLATION DOUBLEWALL CONNECTOR USA CANADA A. Sidewall to unit 10" 254 mm B. Backwall to unit 2" 51 mm C. Cornerwall to unit 5" 127 mm D. Sidewall to connector 15.5" 394 mm E. Backwall to connector 6.5" 165 mm F. Cornerwall to connector 10" 254 mm G. Unit to ceiling 54.5" 1384 mm H. Floor to ceiling 84" 2134 mm 8