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17A-150 (4) BP-2022-0871 44 FOX FARMS RD COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 17A-150-001 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-2022-0871 PERMISSION IS HEREBY GRANTE TO: Project# LINER Contractor: License: Est. Cost: DOUGLAS L'ABBEE 99401 Const.Class: Exp. Date:01/06/2024 Use Group: Owner: EINSTEIN BARSHAY, RICHARD& TR•CY Lot Size (sq.ft.) Zoning: URA Applicant: THE FIRE PLACE Applicant Address Phone: Insurance: PO BOX 606 (413)397-3463 014005033011 16 WHATLEY, MA 01093 ISSUED ON:07/25/2022 TO PERFORM THE FOLLOWING WORK: INSTALL LINER INTO FLUE 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 VIOL TION OF ANY OF ITS RULES AND REGULATIONS. Signature: 0 ( Yl pin, .. Fees Paid: $40.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner City of Northampton �l!?yamf k�� i ECElV�Lj' ____Massachusetts G'{ _� -i K a�$ ": la ((�,,4 t.; DEPAR r NT OF BUILDING INSPECTIONS 7 :ea r., 212 in Street • Municipal Building S� �a 1`.; xu JUL 2022 Nor hampton, MA 01060 s jY Ni.-5 / 7.4- /5° I)FPT OF 6UILDIM1JG INSPECTIONS APPLICATION FOR-SOLID FUEL APPLIANCE INSTALLATION Property Information Owners Name: Rick r cf.3'co-/a y Address: 41(i `:0K f rr s g / I/arc'Icc Ot- o-fot o (No.) (Street Address) Phone: ' i >?a/- 77°3‘ Cell: Email: fleA c6trshY & ,f.yner,/ ccn-1 • Owners Signature: ,,._ Date: /so'-zz_ Contractor's Information (If Applicable) Name: Do07/:5 / f�M,- Phone: (//.. 37:7 5/6 Construction Supervisor's License #: ;/'y'Sio/ Expiration: / -' ,2/ Home Impr. Contractor License #: /"p f 77 Expiration: 7/- /1-- Stove Information /As 4din7 f x ss' /- (R�o � Type of Fuel (check all that apply): Wood '( Pellet Coal Location: lfi/j-/ Acur Freestanding Insert X Manufacturer: 4ap' Model: 6/?sajer i n5,--r—/- _--_-_-_-------FOR BUILDING DEPARTMENT USE ONLY------_--_-__---_--__------ Permit# ).1- a'71 Date Applied: • Total all Fees: $ ‘ia C K 1 r/ . {ZY Building Official: 1�`k.ht,,, r Z s Date Issued: '7--Z -ZOZz (P»xl Signature of Building Official: ,f j� • The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations J-�-f— - Lafayette City Center 2 Avenue de Lafayette, Boston.MA 02111-1750 14')vr9!Ill ass.g ov/duf Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Or*anization'Individual):THE FIRE PLACE Address:100 STATE ROAD City/State/Zip:WHATELY, MA 01093 Phone#:413-397-3463 Are you an employer? Check the appropriate box: Type of project(required): 1.0 I am a employer with 10 4. 0 I am a general contractor and I 6 0 New construction employees(full and/or part-time)." have hired the sub-contractors 2.0 I am a sole proprietor or partner- listed on the attached sheet. 7. Q Remodeling ship and have no employees These sub-contractors have 8. Q Demolition working for me in anycapacity. employees and have workers' P Y. 9. Q Building addition [No workers' comp. insurance comp.insurance..- required.] 5. Q We arc a corporation and its 10.0 Electrical repairs or additions 3.0 I am a homeowner doing all work officers have exercised their 11.E1 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.1' c. 152,§1(4).and we have no employees. [No workers' 13.0 Other comp. insurance required.] '°Any applicant that checks box g t must also fill out the section below showing their workers compensation policy information. t Homeowners who submit this affidavit indicating they arc 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 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:MA RETAIL MERCHANTS WC GROUP INC Policy#or Self-ins.Lic.#:01400503301116 Expiration Date:1-1-23 Job Site Address: 01 cO)e 6,171S �T� City/State/Zip. 1/o/Ynr,c, fit 1.Q 6/©6o Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to S I.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 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 DLA for insurance coverage verification. I do hereby certif.,under the pains atrrj Agnalties of perjury that the information provided above is true and correct. � 7/75 2 SSignature: . t d Date: � � Phone .: 413-397-3463 • 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): lOBoard of Health 20 Building Department 30City/Tow'n Clerk 4.0 Electrical Inspector 50Plumhing Inspector 6.DOther Contact Person: Phone#: Li 32l 20 Fireplace Insert Installation (for qualified installers only) Insert Dimensions 6"(152mm)Dia. 5-7/8" (149mm) Small-28-1/2" ��><1 23-5/8" (724mm) 600mm) I -3/8" (213mm�-----)A 3/4"(19mm) Large-30-1/2" �,� (775mm) / \ r r ii, 20"(508mm) III ��� 20-3/4" e "' (527mm)� u� ��i III uill 1 III III Small-40" III (1016mm) `: III "1 a t:! 14-1/4" Large- m �� (362mm) (1067mm\ (413mm) ©Travis Industries 4/26/2021 - 1510 Answer Fireplace Insert Installation (for qualified installers only) 21 Fireplace Requirements Minimum fireplace size requirements are shown below. Minimum Fireplace Size Masonry Z.C. (Metal) Fireplace Fireplace (a)Height(front) 20-3/4" 20-3/4" (528mm) (528mm) Co (b)Height(rear) 20-3/4" 20-3/4" 64stib (528mm) (528mm) Mai (c)Width(front) 23-5/8" 2s-5/8°** te/ (601mm) (651mm) (d)Width(rear) 23-5/8" 25-5/8' (601mm) (651mm) O/1,C, (e)Depth* 14-1/2" 15-1/2"** Orb (369mm) (394mm) j 4Sfib/e \ (f)Hearth Depth* 18" 18" Fa (Includes insert depth on hearth (458mm)(US) (458mm)(US) O c��g plus required hearth extension) l a 20" 20" (508mm)(Canada) (508mm)(Canada) O (g)Hearth Width 35-5/8" 35-5/8" (905mm)(US) (905mm)(US) CO 39-5/8" 39-5/8" (1007mm)(Canada) (1007mm)(Canada) \ tic/),c . O� (h)Facing Width 42-5/8" 47-5/8" Ostibi (1083mm) (1210mm) • eye (i)Facing Height 32" 32" \ a7h (above base of Insert) (813mm) (813mm) 0 (j)Mantel Height 35-1/2" 44" i (above base of Insert) (902mm) (1118mm) *This dimension is for a panel with no trim. If using the optional trim the insert will extend 3-1/4"(77mm)onto the hearth. **1"(26mm)Clearance to fireplace walls is required for Z.C.Fireplaces Fireplace Altered Tag Attach the "This fireplace has been altered..." plate to the fireplace(use two screws or other suitable method). You may wish to place it in a location where it will be covered by the surround panels. -,-, *".'M PZ,4 i -iRgg it *s*'*'*''' ,..N.%,,,,..,„,,,,,,,. 'N'44%..%.....: 4 EOFfr © Travis Industries 4/26/2021 - 1510 Answer • 22 Fireplace Insert Installation (for qualified installers only) Insert Placement Requirements • The insert must be placed so that no combustibles are within, or can swing within (e.g. drapes, doors), 36"of the front of the insert. • Insert and hearth must be installed on a level, secure floor • The minimum clearances,facing, and hearth requirements listed below must be met. Follow the clearances for the type of fireplace being used—(masonry or zero-clearance-metal). Minimum Clearances Masonry Z.C. (Metal) Fireplace Fireplace ___Z- (k)Sidewall 13" 13" cO�bes (331mm) (331mm) comb b61eManr (I)Side Facing 9-1/2" 12" Gsbby ei (242mm) (305mm) eT 0 °Fa . (m)Top Facing 32" 32" Side �a°i� Ge9 (813mm) (813mm) Wall — " (n)Mantel 35-1/2" 44" t''' 1 . (889mm) (1118mm) (o)Front Hearth(does not include 16" 16" insert extension"x" (407mm)(US) (407mm)(US) I� (458mm)(Canada) (458mm)(Canada) `.��E (p)Side Hearth 6" 6" (153mm)(US) (153mm)(US) 0 8" 8„ (204mm)(Canada) (204mm)(Canada) �Oj C ` (q)Front of Insert 36" 36" 41 yea,`jb/e \\✓0 (915mm) (915mm) �i, O (x)Extension onto Hearth* (51mm*) (51mm*) *This dimension is for a panel with no trim. If using the optional trim the insert will extend 3-1/4"(77mm)onto the hearth. Masonry Fireplace - Hearth Extension Requirements • Must extend 16" (USA)or 18" (Canada) in front of the insert and 6" (USA)or 8" (Canada)on both sides USA- min. 18" (458mm)deep by 35-5/8" (905mm) wide Canada- min. 20" (508mm)deep by 39-5/8" (1007mm)wide • Masonry hearth extensions must be non-combustible and at least .018"thick (26gauge). Masonry Fireplace Requirements CANADA ONLY: The fireplace insert must be installed with a continuous chimney liner of 6"diameter extending from the fireplace insert to the top of the chimney. The chimney liner must conform to the Class 3 requirement of Can/ULC S635, Standard Lining Systems for Existing Masonry or Factory- Built Chimney&Vents, or CAN/ULC S640, Standard for Lining Systems for New Masonry Chimneys. • Chimney must have a clay tile liner or a stainless steel liner(positive connection). • Entire fireplace, including chimney, must be clean and undamaged. Any damage must be repaired prior to installation of the insert. • Chimney height: 15' (4.5M) minimum; 33' (10M) maximum. • The fireplace insert must be placed on a masonry hearth built to UBC standards. ©Travis Industries 4/26/2021 - 1510 Answer Fireplace Insert Installation (for qualified installers only) 25 Insert with Positive Connection I Insert with Direct Connection (Masonry REQUIRED IN CANADA. Fireplace) NOT ALLOWED IN CANADA. A block-off plate or other non-combustible sealing device (e.g. damper adapter) is required. It must seal the chimney to ensure smoke does not enter the home while providing the chimney system with sufficient draft. to 11 n m '44•O•j.OQ - I D B 1134 ntaZt.-s [J%---L__J-I iu1- OC :C C ® =C II =I DM ]OI iI OC OI OC OI OC jC OC :C II ]OI DC ]OI OC it 01 DC DC CI CC II QI DC 01 �C O1 C OI f OC �I OC CI CC.... 01 C CC DC OC CC CC =C INC 101 ■C 7 101 O I =C O I ` :C ■' I w ]OI ■O v )OI II =C INIII II =C ■ I )OI • — ]OI ■ r OOI S Mil OOI OOC I ~ .ili Om OO1 it 1*OOI fAmi OC OC .COI COI �'CC ICDC Wl OI Wu ___IC - IC JOI JOI JOI JOI L ILTLITl fi ii ii LI I I CI _aU 11F Figure 12 © Travis Industries 4/26/2021 - 1510 Answer