30A-023 (4) Specifications
CLEARANCES ]o COMBUSTIBLES - 1200-C INSERT:
Table 2: 1200-C Insert Clearance tmCombustibles.
A Minimum clearance to an unshielded side wall 14 in (254 mm)
B Minimum clearance to an unshielded 8" (203 21 in (533 mm)
mm) mantel
C Minimum top facing (protruding 3/4" [19 mm])
clearance
D Minimum side facing (protruding 3/4" [19 mm]) I in (25 mm)
clearance A
E t From front of door opening to edge of floor USA 16 in (406 mm)
pro ec ion CND 18 in (450 mm)
F t From side/back of unit to edge of floor USA 6 in (152 mm) F
protection CND 8 in (203 mm)
t FLOOR PROTECTION:
If unit is raised 0 - 2 in (O 51 mm); 1 in (25 mm) non-combustible material with Rva|ue 0.59 or equivalent.
I[unit is raised 2 D in (51 203 mm); 0.5 in (13 mm) non-combustible material with Rva|ue = 0.50 or equivalent.
If unit is raised greater than 8 in (203 mm) or more; any non-combustible material can be used.
Table 3: Reduction in (B) Minimum Clearance from 1200-Cto 8~(oU3 mm) Mantel.
Type of protection Modified Clearance
A minimum of .013 in (0.33 mm) sheet metal spaced out 1 in (25 mm) by 10.50 in (267 mm)
non-combustible spacers.
Ceramic tiles, or equivalent non-combustible material on non-combustible 14.00 in (356 mm)
supports and spaced out 1 in (25 mm) by non-combustible spacers.
Ceramic tiles, or equivalent non-combustible material on non-combustible
supports with a minimum of .013 in (0.33 mm) sheet metal spaced out I in 10.50 in (267 mm)
(25 mm) by non-combustible spacers.
NOTES:
(1) Mantel protection must have at least ] in (75 mm) edge clearance on all sides, except as provided in Note 4.
(Z) If an adhesive is used to support non-combustible material, it shall not lose adhesive qualities at temperatures
likely to be encountered and shall not contribute a significant combustible load.
(3) Heat shield mounting hardware attached to combustible materials must be placed at the lateral extremities of
the shield.
(4) Minimum clearance tounprotected walls and ceilings must be maintained.
(5) Clearances may only be reduced with shielding acceptable tothe local authurity.
Table 4. IL200-C Insert Minimum Fireplace Install Size.
Masonry Zero Clearance
Minimum Depth 181/4 in (464 mm) 183/4 in (476 rnm)
Minimum Width at back of fireplace 225/8 in (575 mm) 23 in (584 mm)_
Minimum Width at front of fireplace 31% in (805 mm) 32 in (813 mm)
**Minimum Height 191/4 in (489 mm) or 20 in (508 mm)
** lf the masonry lintel height is only 1Q1/4in (48A mm)to193/4in (5OZ mm) refer UoIwsmuxr(ON MooIp/cmzomsFon
IwsmuxrIumWITx 10\/4'' (48Amm) Hrs* LmreI_ Iwssm
11
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MASONRY FIREPLACE INSTALLATION:
Unless you are experienced, we recommend installation by your dealer or a
professional installer~
Install only in a masonry fireplace with 8 good-condition chimney at least 15 ft (4.6 rn) high, both of
which have been constructed in accordance with the building code. Refer to Tables 4 and 7 for minimum
masonry fireplace dimensions. Be sure the fireplace and chimney are clean and sound without any cracks
or loose mortar. Do not remove any bricks or mortar from the fireplace.
Rain Cap If there is a combustible floor in front of the
masonry fireplace, the fireplace insert must
Steel Plate or Flashing be 8"/203 mm\ above the combustible floor,
and Moor protection must be provided 18"
(457 nnnn) in front of the fireplace insert
and 8" (20] nnnn) to each side of the unit.
,,.-Flexible or Rigid 6" Refer also to SpsczpzcAroms CLs^x^mcss To
Stainless Steel Liner ComousnaLss- 1ZOO-CImssxrand SPec/nc^Jzows
- CLEARANCES To Comnusr/nLss - 1700'C lmssnT.
1. Remove any fireplace damper or fasten in
a permanent Op8D position.
2. KIN CANADA) The stove is vented with
8 6"stainless steel liner that goes directly to
the top Of the chimney and is covered with
Mantel a rain Cap. The chimney top is sealed with
a flashing or steel plate that supports the
p Facing weight of the chimney liner. The installation
OluS1 CODh}r0 to the liner's manufacturer's
|D9trU[t\OnS.
Damper Removed
or Fastened Open This fireplace nnU5t be installed with a
Surround Panel continuous liner of 6" diameter (CANADA
ONLY) extending from the fireplace insert to
Sheet Metal Screws the top Of the [hinnn8y. The chimney liner
Fastening Collar to nnUSt conform to the Class 3 requirements
Stainless Steel Liner
Of CAN/ULC-S635 Standard for Lining
SvStennS for Existing Masonry or Factory-
Built Chimneys and Vents, or CAN/ULC-S640
Standard for Lining Systems for New Masonry
Chimneys.
ho appliance when installed,
must follow local building codes, in the
Protection (203 m) absence of local building codes, with the
current NFPA 211 Standard for Chimneys,
Masonry Fireplace Combustible Floor Fireplaces, Vents, and Solid Fuel-Burning
Figure 18: Insert Installation into existing fireplace with Appliances.
hearth.
16
The Commonwealth of Massachusetts
Department of Industrial Accidents
�w4
Office of Investigations
I Congress Street, Suite 100
A, Boston,MA 02114-2017
--°' www mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (13usiness/Organiiation/Individual): BERNARDSTON FARMERS SUPPLY
Address:43 RIVER STREET
City/State/Zip: BERNARDSTON MA 01337 Phone#:413-648-9311
Are you an employer? Check the appropriate box: Type of project(required):
1.0 1 am a employer with 10 4. 0 1 am a general contractor and 1 6. ❑ New construction
employees (full and/or part-time).* have hired the sub-contractors
2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling
ship and have no employees These sub-contractors have 8. ❑ Demolition
working for me in any capacity. employees and have workers' 9. ❑ Building*addition
[No workers' comp. insurance comp. insurance.t
required.] 5. ❑ We are a corporation and its 10.El Electrical repairs or additions
officers have exercised their I I. Plumbing repairs or additions
3.❑ 1 am a homeowner doing all work � p
myself. [No workers' comp. right of exemption per MGL 12 ❑ Roof repairs
insurance required.] c. 152, §1(4),and we have no
employees. [No workers' 13.7 Other
comp. insurance required.]
*Any applicant that checks box#I must also lilt out the section below showing their workers'compensation policy information.
Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a Lickv 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
anplovees. 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 polio'and job site
information.
Insurance Company Name: PEERLESS INSURANCE
Policy#or Self-ins. Lic. #:WC8165644 Expiration Date: 7/1/15
Job Site Address: 7 cY h�'Y! '{ � c^ City/State/Zip: MA clffc
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
line 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.
do hereby certify zder the pains and pen ies of perjury that the information provided above is true and correct.
Signature: Date: /
Phone#:
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#:
ty of Northampton
--
Massachusetts
ci
1n J44:.- r ' OF BI zW-TffG M95FO=OPS :
StLeet • Mazacipal B1I.UdTng
_ r l
Nnrt-hanpton, MA 01060
P Un -
N
GINOLE OR TWO PAMILV SOLln FUEL APPLIANCE PERMIT APPLICATION
FOR WOOD, COAL, PELLET, CORN, STRAW OR SIMILAR STOVES, OR FIREPLACE INSERTS
Permit Pee: $25.00 Check#
PLEASE TYPE OR PRINT ALL INFORMATION
1. NameofApp6gnt bc-c'
5- 6,-,1
Address: �" %ter f(��/� cs71 t n /Y1 A Telephone:
2_ Owner of Property: L G'rd
Address: // r/CS t�� / l6/�d�t Telephone:
3. Status of Applicant Owner Contractor
4. Type or Brand of Stove: k-/Ji� dzD ah�l(0 6td0o0 gsPr" - OAS' st %ham,
A r /�►
If applicant is not the homeowner
Construction Supervisor's License Number 9� Expiration Date 1-6 -14
Home Improvement Contractor Registration Number Co O I!S Expiration Date ? S
All Applicants must complete a Workers Compensation Insurance Affi-davit before we can issue a permit
5. Certification:t hereby certify that the information contained herein is true and accurate to the best
of my knowledge.
n
DATE: APPLICANT'S SIGNATURE
DATE: HOMEOWNER'S SIGNATURE /
APPROVED
DATE: BUILDING OFFICIAL
48 LEXINGTON AVE BP-2015-0496
GIs#: COMMONWEALTH OF MASSACHUSETTS
MapBlock: 30A-023 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Cate oa: woodstove BUILDING PERMIT
Permit# BP-2015-0496
Project# JS-2015-000928
Est.Cost:
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: BERNARDSTON FARMERS SUPPLY 99401
Lot Size(sq. ft.): 11194.92 Owner: MESCON CORY&BEN BAUMER
Zoning: URB(100)/ Applicant: BERNARDSTON FARMERS SUPPLY
AT. 48 LEXINGTON AVE
Applicant Address: Phone: Insurance:
43 RIVER ST (413) 648-9311 WC
BERNARDSTONMA01337 ISSUED ON.1012812014 0:00:00
TO PERFORM THE FOLLOWING WORK.INSTALL ENVIRO CABELLO WOODSTOVE
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:
Driveway Final:
Final: Final:
Rough Frame:
Gas: Fire Department Fireplace/Chimney:
Rough: Oil: Insulation:
Final: Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupancy Signature:
FeeType: Date Paid: Amount:
Building 10/28/2014 0:00:00 $25.00
212 Main Street,Phone(413)587-1240, Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner