35-171 (6) BP-2024-1454
1363 BURTS PIT RD COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
35-171-001 CITY OF NORTHAMPTON
Permit: Solid Fuel
Appliance
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit# BP-2024-1454 PERMISSION IS HEREBY GRANTED TO:
Project# wood stove 2024 Contractor: License:
Est. Cost: 6245 CORY MCGILL 107658
Const.Class: Exp.Date: 05/25/2025
LASTOWSKI, JOANNE T(L/E)PAUL LASTOWSKI
Use Group: Owner: &AMANDA M JOHNSON
Lot Size(sq.ft.)
Zoning: WSP Applicant: CORY MCGILL DBA DONE RIGHT CHIMNEY
Applicant Address Phone: Insurance:
PO BOX 1054 (413)340-1399 WCV 01593200
WILLIAMSBURG, MA 01096
ISSUED ON: 10/31/2024
TO PERFORM THE FOLLOWING WORK:
WOOD 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:
Final: Final: Final: Rough Frame:
Gas: Fire Department Driveway Final: 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.
Signature: 72.
Fees Paid: $60.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
The Commonwealth of Massachusetts n
Board of Building Regulations and StandarA PT 2 9FOR
7
CIPALITY
2024 ' M I
Massachusetts State Building Code, 780 CMR 1 USE
Building Permit Application To Construct,Rep novate OrDe fish-a„; Ret!ised Mar 2011
One-or Two-Family Dwelling
This Section For Official Use Only
Building Permit Number: 4 • }y'/YS 5l Date Applied:
ap ,j1
wilding Official(Print Name) S S azure Date '
SECTION 1: SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map&Parcel Numbers
1363 Burts Pit Road,Northampton,MA 01062
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'
2.1 Owner'of Record: Northampton, MA 01062
Joanne Lastowski p
Name(Print) City,State,ZIP
1363 Burts Pit Road (413)320-0976 N/A
No.and Street Telephone Email Address
SECTION 3: DESCRIPTION OF PROPOSED WORK'(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 j8( Specify:Wood stove install
Brief Description of Proposed Work2:To install(1)Lynwood W76 freestanding wood stove into existing masory chimney.
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1.Building $6,245.61 I. Building Permit Fee: $ Indicate how fee is determined:
2.Electrical $ ❑Standard City/Town Application Fee
❑Total Project Cost3(Item 6)x multiplier x
3.Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire $
Suppression) Total All Fees 11;
Check No. II JCheck Amount: Cash Amount:
6. Total Project Cost: $6,245.61 0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
CS-107568 05/25/2025
Cory McGill License Number Expiration Date
Name of CSL Holder
P.O. Box 1054 List CSL Type(see below) U
No.and Street Type Description
U Unrestricted(Buildings up to 35,000 cu.ft.)
Williamsburg, MA 01096 R Restricted l&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)
Co McGill #178722 08/27/2026
HIC Registration Number Expiration Date
HIC Company Name or HIC Registrant Name
P.O. Box 1054 ContactDoneRight@gmail.com
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 ® No .❑
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.
Joanne Lastowski 10/25/2024
L (0.,2S,2024 00)6 LDT)
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.
Cory McGill PA10/25/2024
Print Owner's or Auth ized 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
__;?! ►= Office of Investigations
_l i_ 1 Congress Street, Suite 100
Boston,MA 02114-2017
�:.• www.mass.gov/dia
Workers'Compensation Insurance Affidavit: General Businesses
Applicant Information Please Print Legibly
Business/Organization Name: Done Right Chimney Inc.
Address:P.O. Box 1054,49 Main Street,#4
City/State/Zip:Williamsburg, MA 01096 Phone#:(413)340-1399
Are you an employer?Check the appropriate box: Business Type(required):
1.0 I am a employer with 13 y 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]** 11.11 Health Care
4.❑ We are a non-profit organization,staffed by volunteers,
with no employees. [No workers' comp. insurance req.] 12.1 Other Services:Chimney&Hearth
*Any applicant that checks box#l 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:49 Main Street,#4
City/State/Zip: Williamsburg, MA 01096
Policy#or Self-ins. Lic. # WCV 01593200 Expiration Date:04/16/2025
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: (r1( ' 2, Date: I DI ZS I ?OLt/
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
They are nationally recognized and are accepted by most local authorities. Your local dealer or
your local building official may have a copy of these regulations.
WARNING!
CHECK ALL LOCAL BUILDING AND SAFETY CODES BEFORE INSTALLATION.
THE INSTALLATION INSTRUCTIONS AND APPROPRIATE CODE REQUIRE-
MENTS MUST BE FOLLOWED EXACTLY AND WITHOUT COMPROMISE. AL-
TERATIONS TO THE STOVE ARE NOT ALLOWED. DO NOT CONNECT THE
STOVE TO A CHIMNEY SYSTEM SERVING ANOTHER STOVE, APPLIANCE OR
ANY AIR DISTRIBUTION DUCT. FAILURE TO FOLLOW THESE INSTRUCTIONS
WILL VOID THE MANUFACTURERS WARRANTY.
WARNING!
THE PROTECTIVE MATERIAL FOR TRANSPORT IS PLACED INSIDE YOUR
STOVE AND BETWEEN THE PLATES OF THE UPPER BAFFLE, REMOVE IT BE-
FORE INSTALLATION. YOU CAN REACH THEM FROM THE TOP OF THE COLLAR
THROUGH THE FRONT OPENING.
NOTE
If you plan to vent your stove into an existing masonry chimney, have the chimney inspected
by a local fire marshal or qualified installer. Remember that the chimney and its location on the
roof heavily influences the stoves performance. An oversized flue may not provide effective draft
and a flue liner may be required. (Observe draft requirements). Consult your dealer or qualified
installer before final selection is made.
You may wish to leave enough room between the stove and the wall to make cleaning easier.
Floor protection
If the stove is to be installed on a combustible floor, the stove must be placed on a noncombus-
tible hearth pad, which extends 8" ( 200 mm measured from the legs) beyond the stove sides
and back, and 18" (455 mm) measured from side and back panels to the front. The floor protec-
tion can be any noncombustible material that has a minimum R- value of 1.0 and listed to UL-
1618.
FLOOR PROTECTOR
18' FRONT
Floor protection for Canada 18" (45 cm)
8- -e . from unit to front of floor protector-and
1/111
8" (20 cm)to the sides.
Floor Protector must be under connector
pipe and 2"(5 cm)to the side fora through
u the wall configuration.
USA 1G
Ca^ada 18'
Page 8
Combustible Wall Clearance for top vent installation
When installing stove the following clearances to combustible materials must be kept.
Chimney connector pipe A B C D E F
6" single wall 16" 18" 16" 27.5" 19.5" 18"
(406 mm) (457 mm) (406 mm) (699 mm) (495 mm) (457 mm)
6" double wall ventilated 16" 10" 8" 27.5" 11.5" 10"
(406 mm) (254 mm) (203 mm) (699 mm) (292 mm) (254 mm)
6" single wall and optional 16" 11" 16" 27.5" 14" 18"
heat shield (406 mm) (279 mm) (406 mm) (699 mm) (356 mm) (457 mm)
6" double wall ventilated 16" 5" 6" 27.5" 8" 8"
and optional heat shield (406 mm) (127 mm) (152 mm) (699 mm) (203 mm) (203 mm)
CLEARANCE TO COMBUSTIBLE SURFACES
TOP VENT OPTION TOP VENT OPTION
BACK WALL ADJACENT WALL
prrFAr4rA
:iH &
..._r
DI
Refer to the chimney connector manufacturer's instructions concerning installation of listed con-
nector pipe, wall thimble and chimney.
Page 9