31A-319 (5) BP-2023-0039
106 VERNON ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
31A-319-001 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-2023-0039 PERMISSION IS HEREBY GRA I ED TO:
Project# WOOD STOVE 2023 Contractor: Licens
Est. Cost: 5775 CORY MCGILL 107658
Const.Class: Exp.Date: 05/25/2023
Use Group: Owner: BERGER DAN H& LAURA A KAT'
Lot Size (sq.ft.)
Zoning: URA Applicant: CORY MCGILL DBA DONE RIGHT HIMNEY
Applicant Address Phone: Insurance:
PO BOX 1054 (413)340-1399 WCV 01525601
WILLIAMSBURG, MA 01096
ISSUED ON: 01/13/2023
TO PERFORM THE FOLLOWING WORK:
WOOD STOVE REPLACEMENT
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 VI o LATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature: ( q 331041M
a/ sJ
Fees Paid: $65.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
RE .a
The Commonwealth of Massachusetts JAN 1 2 2 0 I
Board of Building Regulations and Standards �.-3 O .
MUNICIP' LITY
Massachusetts State Building Code, 780 CMI CI
BuildingPermit Application To Construct, Repair, RenF vaterC)r. nui� c,iNSFe�r�lid Mar 2011
PPp �r.�A o,tf
One-or Two-Family Dwelling
This Section For Official Use Only
Building Pe it Number: /14-)..3^• 3q Date A plied:
1
-2 •
Pe it
1-13-2023
Building Official(Print Name) Signature Date
SECTION 1: SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map& Parcel Numbers
106 Vernon Street, Northampton MA 01060
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 0 Zone: Outside Flood Zone? Municipal 0 On site disposal system 0
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP' I
2.1 Owner'of Record:
Dan Berger, Laura Katz Northampton MA 01060
Name(Print) City,State,ZIP
106 Vernon Street (413) 575-2997 dhb@cbkimmigration.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 Ed Specify: wood stove replacement
Brief Description of Proposed Work2: To sweep chimney and perform a Level 2 Inspection of the chimney system.To,remove
existing wood stove and replace with(1)Regency F2500 free standing wood stove,meeting all clearances per manufacturer specifications
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials) I
1. Building $ 5,775.51 1. Building Permit Fee: $ Indicate how fee is dtermined:
❑Standard City/Town Application Fee
2. Electrical $ ❑Total Project Cost'(Item 6)x multiplier x
3. Plumbing $ 2. Other Fees: $
4. Mechanical (HVAC) $ List:
5. Mechanical (Fire $
Suppression) Total All Fees: $ �i Check No.�,,j Check Amount: Cash Amount:
6.Total Project Cost: $ 5,775.51 ❑Paid in Full 0 Outstanding Balance Due:_
it
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
CS-1 07568 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
Williamsburg, MA 01096 U Unrestricted(Buildings up to 35,000 Cu.ft.)
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 ContactDoneRight@gmail.com I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
#178722 08/27/2024
Cory McGill HIC Registration Number Expiration Date
HIC Company Name or HIC Registrant Name
P.O. Box 1054 ContactDoneRight@gmail.corn
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 El No .0
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.
Dan Berger, Laura Katz 14a7-,.:.,7u.=r, 1/10/23
Print Owner's Name(Electronic Signature) Date
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.
Co McGill Ol110)de23
Print Owner's or Aut orized Agent 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.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/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"
The Commonwealth of Massachusetts
Department of Industrial Accidents
I'.i :fit
= = G Office of Investigations
• �l= 1 Congress Street, Suite 100
___�_{_
• ' Boston,MA 02114-2017
'ago 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 5 employees (full and/ 5. Q 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,alto,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 10.0 Manufacturing
no employees. [No workers' comp. insurance required)** 1 1 ❑ Health Care
4.❑ We are a non-profit organization, staffed by volunteers,
with no employees. [No workers' comp. insurance req.] 12.11 Other Services: Chimney&Hearth
*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#I.
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 pe alties 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 ORD R 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 Offi e 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: AJQJA PiC Date: 0111 0 62
Phone#: (413) 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.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: 106 Vernon Street, Northampton MA 01060
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
0\\ko\Y3?5 (ki'L2)
Date Signature of Permit Applicant
MINIMUM CLEARANCE TO
COMBUSTIBLE MATERIALS B E
Please read the section below carefully as clearances depend on whether the airmate or A
the rear heat deflector is installed on the stove. + , F
Measurements"From Unit"are from the top plate of the stove to a side wall or to a corner, D ® C
and from the rear heat shield to a back wall.
•
Clearances may only be reduced by means approved by the regulatory authority.
Minimum ceiling height-83"(2108mm)
NOTE:This clearance is also required for air space between the appliance and wall/ceiling.
NOTE:Be aware that local Codes and Regulations may override some clearances listed in this manual.
Check with your local inspector.
Residential Installation"C"Vent (Single Wall)
Unit From Unit From Corner From Flue Center-Line
A B C D E F
Medium F2500M with Airmate 16"(406mm) 8.5"(216mm) 7"(178mm) 28"(711mm) 15"(381mm) 19" (483mm)
with Rear Deflector 16"(406mm) 10.5"(267mm) 7"(178mm) 28"(711mm) 17"(432mm) 19" (483mm)
Residential Close Clearance(To be installed with required pipe components)
When the stove is installed as a close clearance residential unit,a listed double wall connector is required from the stove collar to the ceiling level.
Unit From Unit From Corner From Flue Center-Line
A B C D E F
Medium F2500M with Airmate 15"(381mm) 7"(178mm) 5"(127mm) 27"(686mm) 13.5"(343mm) 17" (432mm)
with Rear Deflector 15"(381mm) 9"(229mm) 5"(127mm) 27"(686mm) 15.5"(394mm) 17" (432mm)
Mobile Home Close Clearance(To be installed with required pipe components)
"C"Vent single wall pipe is not approved for Mobile Home installations.(Refer to Mobile Home Instructions.)
Unit From Unit From Corner From Flue Center-Line
A B C D E F
Medium F2500M with Airmate 15" (381mm) 7"(178mm) 5"(127mm) 27"(686mm) 13.5"(343mm) 17" (432mm)
with Rear Deflector 15"(381mm) 9"(229mm) 5"(127mm) 27"(686mm) 15.5"(394mm) 17" (432mm)
2 I F2500 Wood Stove
FLOOR PROTECTION
(CORNER INSTALLATION)
A combustible floor must be protected by non-combustible X ® �p
material(like tile,concrete board,or certified to UL-1618 or
as defined by local codes)extending beneath the heater and
a minimum of 8"(203mm)from each side and minimum 16"
(406mm)**from the front face of the stove and minimum 6"
(152mm)**(or the rear clearance to combustibles whichever O
is smaller)from the rear of the stove.
When installed with horizontal venting,non-combustible floor Y 40440,
protection must beneath the flue pipe and extend 2"(51mm)
beyond each side. for angled corners
Minimum Overall Width(X)of Floor
Protector for all Installations:
Stove F2500M 33-11/16"(856mm) **NOTE:In Canada,floor protection must extend 18"(450mm)to
the front and 8"(203mm)to back of the stove.
Minimum Overall Depth(Y)of Floor Protector
Unit Residential From Edge of Fuel Door
"C"Vent Opening
Y z W
Medium F2500M Canada-49"(1245mm) "6"(152mm) 8" (203mm)
USA- 47"(1194mm)
Minimum Overall Depth(Y)of Floor Protector-Corner Hearth
Reference only when hearth pad is installed to rear wall at minimum pipe clearances.
Hearth Depth
F2500 L M N 0
Residential Installation"C"Vent(Single Wall)
Canada 33-11/16' (856mm) 61-7/16" (1561mm) 51-1/8" (1299mm) 27-5/16" (694mm)
USA 33-11/16" (856mm) 59-7/16" (1510mm) 49-3/4" (1264mm) 25-7/8" (657mm)
Residential Close Clearance(To be installed with required pipe components)
Canada 33-11/16"(856mm) 57-15/16" (1472mm) 48-5/8" (1235mm) 24-13/16" (630mm)
USA 33-11/16"(856mm) 55-15/16"(1421mm) 47-1/4"(1200mm) 23-7/16"(595mm)
M
O
4 I F2500 Wood Stove