23D-045 (3) 119 RIVERSIDE DR BP-2017-0286
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:23D-045 CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category:woodstove BUILDING PERMIT
Permit# BP-2017-0286
Project# JS-2017-000481
Est.Cost: $600.00
Fee:$40.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: THE FIRE PLACE 99401
Lot Size(sq. ft.): 12806.64 Owner: GATRALL JEFFREY
Zoning:URB(100)/ Applicant: THE FIRE PLACE
AT: 119 RIVERSIDE DR
Applicant Address: Phone: Insurance:
P 0 BOX 606 (413)397-3463 0 WC
WHATELYMA01093 ISSUED ON:9/2/2016 0:00:00
TO PERFORM THE FOLLOWING WORK:INSTALL HARMAN ABSOLUTE STOVE
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: Ol: 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:
FeeTeee: Date Paid: Amount:
Building 9/2/2016 0:00:00 $40.00
212 Main Street, Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
City of Northampton
a. rev.` Massachusetts �f `�
pI" t I^y rk i t r I
4. : j i D R ENT OF BUILDING INSPECTIONS I I
' 212 ___a _ Ching
North Elp 7.07z, r 21020
F`` :.) 1
.tN - I ZOIS"S1I GL- OR TWO FAMILY SOLID FUEL . :. P ii. AP O ri
Deva orpuy FO We OD, COAL PELLET.CORN. S:n-.. c s SS, Q _
.wsFrnoX0757 st0
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t. Name of Apphcent: "1 Oy'/
CttI I P66c - 74c /v2cf4'occ.
Address: f6 tier/5 (5/...... �n(nby 644 a/037 -,_ __ - =- WS . 773, an /
Owner of Property: /elute C 4 4 /1
Address: //r/ %211fer5/ cue 'Di . _>.�_ ., s: 3o,3- 123- Vg 77
1 Status of.Applicant : Owner 'V Contracts,'
Type or Brand of Stov=_ 1 uarn't» cksalt,M
5 Estimated Cost --t600 '-
..
if
applicant is not the homeowner::
Contractor name L)cu,fd3 I Ab"s
Construction Supervisors License Number 9 T/0/ Fheenntien Date 7-4 "/r
Home Improvement Contractor Reo si a{ion Number I(04177 Expiration Date //h /9-
All Applicants must complete a Workers Compensation Insurance Affidavit before we can issue e permif
6 Certification: I hearty ceriily ihai the tn;prmation contained herein is true and accurate to the best of my
knowiedoe.
/_--„�'
DATE �'2G �/� PLIC Ni SIGNATURE ehh--- c �
DATE: e-26, it <OMEOW I' R`S SIGNATURE !
A) :
APPROVED / � � L -
DATE: BUILDING OFFICIAL
The Commonwealth of Massachusetts
— Department of Industrial Accidents
■_ __ j
=:--= Office ofInvestigations
1 Congress Street, Suite 100
_"F Boston, MA 02114-2017
www mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual): THE FIRE PLACE
Address:106 STATE RD
City/State/Zip:WHATELY, MA 01093 Phone#:413-397-3463
Are you an employer? Check the appropriate box: Type of project(required):
I.Q I am a employer with 10 4. ❑ I am a general contractor and I 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 g. ❑Demolition
working for me in any capacity. employees and have workers' 9. ❑ Building addition
[No workers' comp. insurance comp. insurance.
required.] 5. ❑ We are a corporation and its lo.❑ Electrical repairs or additions
I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL
12.D Roof repairs
insurance required.] ' c. 152, §I(4),and we have no 13.❑ Other
employees. [No workers'
comp. insurance required.]
*Any applicant that checks box#1 must also fill 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 contactors must submit a new affidavit indicating such.
:Contractors that cheek this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those ensitics have
emplaces. 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. Lie. #:014005033601116 Expiration Date:1-1-2017
Job Site Address: f7 9 �rPr�/dc r. City/State/Zip: I rrn / Q/°6�
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 SI,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 5250.00 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 certiifr undfr t he pains and penalti fperjuty that the information provided above is true and correct.
Signature: Date: a7 t'
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(circle one):
I.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone If:
•
E. Floor Protection Comerto edge dimension for cornerinstallationfloor protection.
Place the stove on a noncombustible floor or floor protector 1----
that extends a minimum of 6 inches (152mm) to the front I
of the Toad door opening,6 inches(152mm)to the sides of 1..- ao- (
the door opening, and 1 inches to the rear. Floor protection r..... Ai
must also extend 2 inches(51 mm)beyond each side of any
horizontal flue pipe. The minimum floor protector material i
•
is 20 gauge sheet metal.Other floor protector materials are i \
ceramic tile,stone, brick.etc. Figure 3.3 - - \)
NOTE for Canadian installation only: Per ULC-5627-00, (3/4. z.
if installed on a combustible floor, the need to provide a -
•
noncombustible floor protector covering the area beneath e
the space heater and extending at least 17/7(450mm)on �� /
the firing side and at least 7.87"(200mm)on the other sides. w /
In Canada, you may follow the smaller U.S. floor
protection requirements ONLY if the user agrees to \ - - M,
completely shut-down the appfiance,and allow It to cool
to where all fire is extinguished and the combustion
blower and its indicator light shuts off,prior to opening
the firebox door or ash door.
Minimum Size floor protection(USA)is 25-7/8"wide By 28" Alternate floor protector dimension may be used as long
deep(658mm X 711mm). as they satisfy the measurement requirements shown
*Floor protection dimensions for the front and sides are below.
measured from the appliance door opening in The United Minimum size floor protection for a corner installation
States.In Canada,the side dimension is measured from the hearth pad is 36"x 36"(USAONLY).Note:Floor protector
widest part of the appliance. WILL NOT touch the wall.
L L F. Mobile Home Installation
-a� The—
_ .. When installing this unit in a mobile home, several
--- ''
requirements must be followed:
• s 1. The unit must be bolted to the floor in places. This can
be done using 114"lag screws through the skid bolt down
[1,--Jholes located at the base of the unit. Note: Lag bolt must
• be installed from the bottom up.
—, 2. The unit must be connected to an outside combustion
air inlet. Proper supports and spark arresters must be
considered when installing venting. See "Termination
Location and Vent Information"Section D.
;' 4.
3. Floor protection and clearances must be followed as
s" shown.
. :., - -_ -�.-:% 4. Unit must be grounded to the metal frame of the mobile
J J home.
USA CANADA
K
Figure 3.3 0
Floor Protectionu3 Canada lir
Requirements
J Sides 6" 200mm c I ..
K Front 6" 450mm -�, .rJ
L Rear 1" 25mm
Note: Measurement"L"is even with the rear of the hopper in the Install Vd"tag bolts here.
US ONLY
Note: Measurement "K" is measured from the glass in the US
ONLY
9 Harman€ • Absoiule43 installation Manuai_R5 - 2015. • 09/15 3-90-00778i
B. Non-Combustible Materials Specification
Material which will not ignite and burn. Such materials are _
those consisting entirely of steel, iron, brick, tile, concrete, 2"(51mm)
slate,glass or plasters,or any combination thereof.
Materials that are reported as passing ASTM E 136, -
Standard Test Method for Behavior of Materials in ( •
a Vertical Tube Furnace at 750° C and UL763 shall be I
considered non-combustible materials.
- 6"{t52mm7
C. Combustible Materials Specification
Materials made of or surfaced with wood, compressed _ r
paper, plant fibers, plastics,or other material that can ignite �_ t--E --_
and burn, whether flame proofed or not,or plastered or un-
plastered shall be considered combustible materials.
D. Clearances to Combustibles 6•(450mm)
When selecting a location for the appliance it is important to
consider the required clearances to wails(see Figure 3.2).
A WARNING
6.25"
RISK OF FIRE OR BURNS! Provide adequate (159mm)
clearance around air openings and for service /
access.Due to high temperatures, the appliance should •
�`VA
be located out of traffic and away from furniture and _` L,
draperies.
NOTICE:Illustrations reflect typical installations and are FOR
DESIGN PURPOSES ONLY Actual installation may vary due u a,
to individual design preference. 3 u
Place the stove away from combustible walls at least as far
as shown in Figure 3.2.
Note that the clearances shown are minimum for safety but do
not leave much room for access when cleaning or servicing.
Please take this into account when placing the stove.
When installing the unit into an alcove it is important to NOTE: Top of unit must be a minimum of 12"(305mm)to
consider the required clearances listed below. ceiling
Figure 3.2
I® ® -- - WM A CAUTION
. r
� ; ii bill THIS APPLIANCE MUST BE VENTED TO THE OUTSIDE.
1
� sNOTICE: Clearances may only be reduced by means
o
approved by the regulatory authority having jurisdiction,
M._. U Due to high temperatures, the stove should be placed away
from traffic, furniture and draperies.
al 36"Wide I Children and adults should be alerted to the hazards of high
Elli MI surface temperatures and should stay away to avoid burns
to skin andler clothing.
-- L13 Young children should be carefully supervised when they are
Height Width 36,Depth 024"
in the same room as the stove.
Clothing and other fammable materials should not be placed
on or near this unit.
e Harman@ • Absolute43Insaialon Manual R5 • 2015-_• 09/15 3-90-00775i