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17C-120 (10) BP-2022-0886 34 SHEFFIELD LN COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 17C-120-001 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-2022-0886 PERMISSIONIS HEREBY GRANTED TO: Project# CHIMNEY RELINE Contractor: License: Est. Cost: 5390 CORY MCGILL 107658 Const.Class: Exp.Date:05/25/2023 Use Group: Owner: • C BENNETT MARK K& JANET Lot Size (sq.ft.) Zoning: URB Applicant: CORY MCGILL DBA DONE RIGHT C IIMNEY Applicant Address Phone: Insurance: PO BOX 1054 (413)340-1399 WCV 01525600 WILLIAMSBURG, MA 01096 ISSUED ON:07/28/2022 TO PERFORM THE FOLLOWING WORK: CHIMNEY RE-LINE 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: 9-11 e, • ' 1• )2 • Fees Paid: $65.00 212 Main Street, Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner I 9 EC j ' The Commonwealth of Massachuseits JUL t 2 Board of Building Regulations and Standard 3 2C2 iFOR ! Massachusetts State Building Code,780 C mU 'ICIPALITY � USE Building Permit Application To Construct,Repair,Renovate lE his /4,FE�R ' ed Mar 2011 One-or Two-Family Dwelling s This Section For Official Use Only Building P rmit Number: _GU-- ?--a-- gE Date Applied: 55 1/�Z 7•Z8 zoZz Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assess r,Map&Parcel Numb(f T 34 Sheffield Lane ( - 1.1 a 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 0 Zone: _ Outside Flood Zone? Municipal 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP1 2.1 Owner'of Record: Janet Bennett Northampton, MA 01062 Name(Print) City,State,ZIP 34 Sheffield Lane (413) 559-1446 janetmcvey@hotmail.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 ❑ Repairs(s) 0 Alteration(s) El Addition 0 Demolition Cl Accessory Bldg.0 Number of Units Other oil Specify: Chimney Re-lining Brief Description of Proposed Work2: To install a 5"x 25', pre-insulated Elite Series Stainless 316 Steel tee liner kit, into existing masonry chimney, after completing a Level 2 Inspection, and breaking out clay tiles, and connect to existing heating system. SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ 5,390.78 I. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ 0 Standard City/Town Application Fee ❑Total Project Costa(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire $ Total All Fees:$ -1..r Suppression) Check No.MI Check Amount. Cash Amount: 6.Total Project Cost: $ 5,390.78 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CS-107568 05/25/2023 Cory McGillLicense Number Expiration Date Name of CSL Holder List CSL Type(sec below) U P.O. Box 1054 ___ Type I Description No.and Sired U } Unrestricted(Buildinv up to 35,000 en.fl.l WtlliamsburtMa 01096 _ R Restricted I8:2 Family Dwelling i City.fown.State ZIP _ M Masonry _ RC Roofing Covering _ WS Window and Siding SF Solid Fuel Burning Appliances 413-340-1399 Donerightch,mneyservtces@gmait.com I Insulation Telephone Email address D Demolition 5.2 Registered Nome Improvement Contractor(HIC) 178722 08/27/20221 Cory McGill HIC Registration Number Expiration Date HIC Com any Name or HIC Registrant Name P.O. Box 1054 Donerightchimneyservices@gmail.com No.and Street Email address Williamsburg Ma 01096 413-340-1399 CityrI own,State,ZIP Telephone _i _ _ SECTION 6: WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.C.152.§ 25C(G)) 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 p( No 0 SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHIN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property, hereby authorize Cory McGill i to act on my behalf, in all matters relative to work authorized by this building permit application. Janet BennettnA/N.....ut (_ - ifroon- 41 , '�Print Owner's Name(Elecgnature) ate SECTION 7b: OWNER'OR AUTHORIZED AGENT DECLARATION By entering my name below.I hereby attest under the pains and penalties ofperjury that all of the information contained in this application is true and accurate to the best of my knowledge and understanding, Cory McGill :> ; 7 47/a/fd9.— Print Owner's or Authorized • _,ent's Name(Electronic Signature) 5 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.govtnca Information on the Construction Supervisor License can be found at ww v.mass.e,ov.idos 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 Projt ct Square Footage"may be substituted for"Total Project Cost" M The Commonwealth of Massachusetts Department of Industrial Accidents 4,=' 9i0► l Office of Investigations . ;`�l= 1 Congress Street, Suite 100 j Boston,MA 02119-2017 '.. =t www.mass.gov/dia Workers' Compensation Insurance Affidavit: General Businesses Applicant Information Please Print Legibly Business/Organization Name: Done Right Chimney Address: P.O. Box 1054,45 Main Street, Unit B City/State/Zip:Williamsburg, MA 01096 Phone#: (413)340-1399 Are you an employer? Check the appropriate box: Business Type(required): 1.❑■ I am a employer with 2 employees (full and/ 5. 0 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. ❑ Entertainment their right of exemption per c. 152, §1(4),and we have 10.❑Manufacturing no employees. [No workers' comp. insurance required]** II.❑ Health Care 4.❑ We are a non-profit organization, staffed by volunteers, with no employees. [No workers' comp. insurance req.] 12.i Other Services: Chimney&Hearth *My applicant that checks box#1 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 41. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy information. Insurance Company Name:Atlantic Charter Insurance Company Insurer's Address:45 Main Street, Unit B City/State/Zip: Williamsburg, MA 01096 Policy#or Self-ins. Lic. # WCV 01525601 Expiration Date:06/28/2023 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$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 certify,under the pains and penalties of perjury that the information provided above is true and correct. Signature: 7-111-� � " Date: 7/I%7o JPhone#: ['1'3 . 3 4O 131c( 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.Licensing Board 5.Selectmen's Office 6.Other Contact Person: Phone#: www.mass.gov/dia 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: 34 Sheffield Lane, Northampton, MA 01062 The debris will be transported by: Done Right Chimney The debris will be received by: valley Recycling, 234 Easthampton Rd, Northampton, MA 01060 Building permit number: Name of Permit Applicant Cory McGill dba Done Right Chimney 7/8/0- Date Signature of Permit Applicant INSTALLATION INSTRUCTIONS Phone:888-900 8106 FOR BEST-Flex Model "PI" Pre-Insulated Fax:sss 392 4432 mu am mil mi. iiiii )Nt& STAINLESS STEEL CHIMNEY LINERS BEST-Flex Model "PI Web:"www.NewEnglandChimneySupply.com 34 Commerce Street,Williston VT 05495 Pre-Insulated sesr New England Supply PRODUCTS STAINLESS STEEL CHIMNEY LINERS BEST-Flex Model"PI"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 • BEST-Wrap and a protective aluminum sleeve has already been assembled around the liner • BEST-Wrap is one half inch(1/2")thick,eight pound density,ceramic wool blanket with a three mil aluminum foil face. • Best-Flex Pre-insulated Liners are created from a variety of New England Supply's Liners;Including Best Flex Lightwall,Elite Series,Heavywall,& Smoothwall liners. • The BEST-Flex Pre-Insulated 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,interlocked 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 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 Pre-Insulated Liner is already insulated with a foil-faced ceramic wool blanket&protective shell that meets UL 1777&ULC S635 standards for chimney exteriors with zero clearance to combustibles. • BEST-Flex Stainless Steel Chimney Liner comes with a Lifetime Warranty for all fuels,with appliance efficiencies at 83 percent or lower. • BEST-flex Pre-Insulated Stainless Steel Liners DO NOT need any additional insulation to meet the zero clearance inside&outside the masonry mass. MATERIALS REQUIRED FOR BEST-Flex PRE-INSULATED STAINLESS STEEL LINER INSTALLATION: 4. Pre-Insulated Liner-"PI" SA-Stove Adapter / �` w TT/TB-Two piece or one piece tee i ' TEC-Tee Cap w EA/EF- 15°-90°elbow .,,.1 '/., .`4, C/CC-Coupler Screws/Rivets OPTION A 4� ' OPTION B TP-Top Plate mho.dx TPCC-Liner Cap TC-Top Clamp OR OR -Top Plate0 40, OR. SC-Storm Collar CL-Liner Cap(square/round) Ito