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BP-2023-0089 183 OVERLOOK DR COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 29-577-001 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-2023-0089 PERMISSION IS HEREBY GRANTED TO: Project# WOOD INSERT 2023 Contractor: License: Est. Cost: 6200 CORY MCGILL 107658 Const.Class: Exp.Date: 05/25/2023 Use Group: Owner: A LASHWAY LANCE L &SHARON Lot Size (sq.ft.) Zoning: WSP Applicant: CORY MCGILL DBA DONE RIGHT CHIMNEY Applicant Address Phone: Insurance: PO BOX 1054 (413)340-1399 WCV 01525601 WILLIAMSBURG, MA 01096 ISSUED ON: 01/26/2023 TO PERFORM THE FOLLOWING WORK: REPLACE WOOD INSERT 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: ;61,14.6 I Fees Paid: $65.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner P The Commonwealth of Massachus tts 1 Board of Building Regulations and S dacN 2 5 7023 ; MUN FOR ICIPALITY J Massachusetts State Building Code, 78 CMR USE Building Permit Application To Construct,Repair, T , , ,7, , ON J Revised Mar 2011 One-or Two-Family Dwelling ,,<„ ^4 r',('' This Section For Official Use Only Building Permit Number:&1)-3.3--- 99 Date Applied: Kievii3 (255 ,//' /"Zeo zoz3 Building Official(Print Name) Signature Sate SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers t` 0WA"\ooIC -c;{ u F\crenc�(` 1 Ave ��jj 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 El Zone: — Outside Flood Zone? Municipal 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP1 2.1 Ownerl of Record: t- ". � OS�v 1 c oc fl\csl_ 'MPr o�' DW. Name(Print) City,State,ZIP V63 dvu\ ' c.,r e. M 11. UV e o_ovorN _ 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 IIYSpecify: rft t 1(.Q v iMQI ' Brief Description of Proposed Work':"gyp b itup CV\ki 4 csyyvt\e\s S Vr`t,. -co 9,e,rfazi m LstNie\ a. \c,,,wc 'r` - -(No iec .cr e r,.krtf„ •v1 sobor Cx\ re..p\V. u v.\:\ ikt ,..\ '.z, . —\o ve,. Xhrov 51Th s\e5 6\z1)(\\Q/A Ss e-. "4 SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ j o I. Building Permit Fee: $ Indicate how fee is determined: (�aob ❑Standard City/Town Application Fee 2.Electrical $ ❑Total Project Cost3(Item 6)x multiplier x 3. Plumbing $ 2. Other Fees: $ 4. Mechanical (HVAC) $ List: 5.Mechanical (Fire $ pd Suppression) Total All Fees: $ C� Check No.3eVi. Check Amount: Cash Amount: 6.Total Project Cost: $ (ic,,acO '71 o^ Paid in Full 0 Outstanding Balance Due: Twgimigifflxvir 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 Williamsburg, MA 01096 U Unrestricted(Buildings up to 35,000 Cu.ft.) City/Town,State,ZIP R Restricted 1&2 Family Dwelling, 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 CoryMcGill 08/27/2024 HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name P.O. Box 1054 ContactDoneRight@gmail.corn No.and Street limail address Williamsburg, MA 01096 (413)340-1399 City/Town,State,ZIP Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152.§ 25d(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 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. 1 (D(.1.has , i�ay/3 Print Owner's Name(Elec nic 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. Cory McGill 0\\ aoa3 Print Owner's or Attiorized Agent's Name(�ic 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/dns 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 I i Department of Industrial Accidents _• _ 1,` Office of Investigations • —' t_ 1 Congress Street, Suite 100 —'�,)s Boston, MA 02114-2017 .4��- 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.El I am a employer with 5 employees (full and/ 5. © 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 10.0 Manufacturing no employees. [No workers' comp. insurance required]** 4.❑ We are a non-profit organization, staffed by volunteers, 11.❑ Health Care with no employees. [No workers' comp. insurance req.] 12.0 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#1. 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. Sel,...,Signature: tr ¶LLA Date: '0iIasIao -3 Phone#:413340-1399 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 /t1UPLAO11 PRO ,it--- CLEARANCES MASONRY AND FACTORY BUILT FIREPLACES The minimum required clearances to combustible materials when installed into a masonry or factory built fireplace are listed below. Unit Adjacent Mantle** Top Side Minimum Minimum To Top of Unit Side Wall (to Top of Facing Facing Hearth Hearth Side 12500 (to Side) Unit) (to Top of Unit) Extension* Extension" G A B C D E F 12"(305mm) 17-1/4"(438mm) 16"(406mm) 1/2"(13mm) 16"(406mm)USA 8"(203mm) 20"(508mm) for3-1/2"(89mm) to side surround 18"(457mm)Canada mantel 22-1/2"(572mm) for 12"(305mm) mantel Side and Top facing is a maximum of 1-1/2"(38mm)thick. 12 10 8 8 4 2 0 za 22 - t�3O )Mantel i 20 I A 18 • 3-1/2"(89m1Mantel 16 B 14--:. 22-1/2" C 12_. (572mm) 10...', 17-1/4" • 8 (438mm) 6 D 4 A 4 ► 4 G ► C 2--i j j Clearances are critical. **Mantel can be installed anywhere in shaded area / F or higher using the above scale. Clearance diagram for installations Note: Ensure the paint that is used on the mantel and the facing is"heat resistant" *Floor Protection or the paint may discolour. Floor thermal insulation/protection with a R value of 2.8 is required if the unit is raised 0-3" WOOD INSERT (0-76mm)(measured from the bottom of the appliance). SPECIFICATIONS Thermal floor protection is not required when unit is raiser greater than 3"(76mm)(measured from the bottom of the appliance). Your fireplace opening requires the following minimum sizes: Please check to ensure that your floor protection and hearth will meet the standards for clearance to combustibles.Your hearth extension must be made from a non-combustible material.Extending Height: 21.5" 16"for US and 18"for Canada—measured from the fuel loading door. Width: 25" Depth: 17" Two faceplates are available to seal the fireplace opening: Standard Oversize 40"W x 30"H 48"W x 33"H 2 12500 Cascades®Wood Fireplace Insert � P