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Building Permit #150-15 - 25 WINDSOR LANE 8/11/2014
C� .ICU U oT a gti0 BUILDING PERMIT AUG 09 - TOWN 9 -TOWN OF NORTH ANDOVER o 14' -) APPLICATION FOR PLAN EXAMINATION Permit NO. Date Received 1 1 ,> Date Issued: U �� v1 1� �9SSACHS t� IMPORTANT: �Applicant must complete all items on this page LOCATION ( p3 V V in6Snr Lo nt PROPERTY OWNER ain , t{� n C Print ) MAP NO: AN—PARCEL:.ZONING DISTRICT: Historic District yes (nDo Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ' One family ❑ Addition 0 Two or more family ❑ Industrial Alteration No. of units: 0 Commercial ❑ Repair, replacement 0 Assessory Bldg 0 Others: 0 Demolition 0 Other 0 Septic 0 Well ❑ Floodplain 0 Wetlands ❑ Watershed District 0 Water/Sewer H\A�-d )L i sh hn mo�oq n,4 rk n et� - S fil i SS hol Vim" Luur Identificatin Please Type or Print Clearly) OWNER: Name: I ed Lan n t PhoneqlV. � Cf y S5q Address: 5 �IV I 12d�a- LQq L CONTRACTOR Name: J' C j� nam K-( Phone: (` 'S3j D lEnof- Address: In&C61 & iWV(WMNI AH 0-5CZ7— Supervisor's Construction License: _ Exp. Date: LD Home Improvement License: 1 11 1Exp. Date: ARCHITECT/ENGINEER 603 0-k-71 a1�� Address: Reg. No. FEE SCHEDULE:BUI�ING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ Wb -3, FEE: $ 511111 -�a Check No.: Receipt No.: a NOTE: Persons contracting with unregist d contractors do not have access o t e u ty and Signature of Age2t/0 ignature of contracto BUILDING PERMIT of C°Dr 6 TOWN OF NORTH ANDOVER o - APPLICATION FOR PLAN EXAMINATION '" nD OH Permit No#: Date Received 7 DgATED gSSACHUSE� Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION Print PROPERTY OWNER Print 100 Year Structure yes no MAP PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District ❑Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please Type or Print Clearly OWNER: Name: Phone: Address: Contractor Name: Phone: Address: i Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ FEE: $ Check No.: Receipt No.: NOTE: Persons contacting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner Signature of contractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ElTanning/Massage/Body Art E] Swimming Pools El Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ i Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ I THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS uY l Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA — (For department use) (kik-g4 e-it tly-j '� r e-C_ 40 Ic�� i i ❑ Notified for pickup Call Email Date Time Contact Name Doc.Building Pennit Revised 2014 Building Department F i The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits I ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work a Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application a Certified Surveyed Plot Plan o Workers Comp Affidavit o Photo Copy of H.I.C. And C.S.L. Licenses o Copy Of Contract ❑ Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) o Mass check Energy Compliance Report (If Applicable) o Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) o Building Permit Application o Certified Proposed Plot Plan o Photo of H.I.C. And C.S.L. Licenses o Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) o Copy of Contract a Mass check Energy Compliance Report a Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg. Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application I Doc:Building Permit Revised 2014 i I Location 2`S No. Date 8 , . - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check#-L411 �' �" Bui)dlng Inspector r -1 NORTH .c . . ve: .. No. 115 * - h ver, MaSS, k,.,,.4It 60 'QA cocLAIII�ic„ew�cw 1 - 2 • � ORATED S U BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System ' OA THIS CERTIFIES THAT ........ LA..................�C BUILDING INSPECTOR ♦............. ........................... .......... ................................... 1 has permission to erect buildings on Foundation �. 1 �� � �. �V�(1I • Rough tobe occupied as .................... ...... ................�..............�..... .............. ... ...........�.!!. Chimney provided that the person accepting this permit shall in every respect conform to the terms of the applicatio inal on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR • UNLESS CONSTRUCTION STARTS Rough Service ............... :... . . ..... .... ..................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises — Do Not Remove . Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. Large Flush 2 Introduction Wood Insert Introduction rM We welcome you as a new owner of a Large Flush Wood Insert. In purchasing a Large Flush Wood Insert you have joined the growing ranks of concerned individuals whose selection of an energy system reflects TRAVIS INDUSTRIES (Rectangular or Arched) both a concern for the environment and aesthetics. This insert is one of the finest appliances the world HOUSE O F FIRE over. This manual will explain the installation,operation,and maintenance of this appliance. Please familiarize yourself with the Owner's Manual before operating your appliance and save the manual for future reference. Included are helpful hints and suggestions which will make the installation and operation of your new appliance an easier and more enjoyable experience. We offer our continual support and guidance to with H vb ri d-Fyre TM Te c h n o/o_q v help you achieve the maximum benefit and enjoyment from your appliance. Important Information No other Large Flush Wood Insert appliance has the Register your warranty online at: same serial number as yours. The serial number is stamped onto the label on the back of the appliance. n.. traviswarranty.com This serial number will be needed in case you require Or,mail your warranty card to: service of any type. Travis Industries House of Fire 4800 Harbour Pointe Blvd.SW Model: Large Flush Wood Insert Mukilteo,WA 98275 Serial Number: Save Your Bill of Sale. To receive full warranty coverage,you will Owner's Manual WARNING' Purchase Date: need to show evidence of the date you purchased your heater. Do not mail your Bill HOT GLASS WILL Purchased From: of Sale to us. CAUSE Masonry Fireplace Insert 00 NOT TOUCH GLASS ° We suggest that you attach your Bill of Sale UNTIL COOLED. to this page so that you will have all the Zero-Clearance(Metal)Fireplace Insert ° NEVER ALLOW CHILDREN information you need in one place should the Save these instructions for future reference TO TOUCH GLASS. need for service or information occur. SAFETYNOTICE. HA„oNAL We suggest that our woodburning hearth ui�sTnrii�products be installed and serviced by If this appliance is not properly installed, a house fire may result. by the NatioswhoareceInstit te'(NFn the .S. pp p p y y by the National Fireplace Institute°(NFI)as For your safety, follow the installation directions. Contact local certified ed nburin ningSada bpecialissorwhoare building or fire officials about restrictions and installation CERTIFIED y 0 Wood Energy Technical §wood Eneyy inspection requirements in your area. TraininglWETT). Travis Industries, Inc. L 4800 Harbour Pointe Blvd.SW ©Copyright 2013,T.I. COT us Mukilteo,WA 98275 $10.00 100-01273 Listed www.travisproducts.com 4111118 Intertek Tested to:U.L.1482&ULC S628 ©Travis Industries 100-01273 4111118 Table of Contents 3 4 Safety Precautions The viewing door must be Gasoline or other flammable closed and latched during liquids must never be used to operation. start the fire or"Freshen Up"the Introduction............. Inspecting&Cleaning the Combustor.................19 fire. Do not store or use •-••••••••••••••••-••-•••••••••••••••••••2 Smoke from this appliance may Important Informalion......................................2 Starting a Fire.................................................20 active a smoke detector when as gasoline or other flammable Installation Options...... Adjusting the Bum Rate................................21 the door is open. liquids in the vicinity of this Features............................................................6 Approximate Air Control Settings:.......................21 Never block free airflow through Heating Speccations.....................................6 Ash Removal..................................................21 the air vents on this appliance. Dimensions.......................................................6 Blower Operation...........................................22 Re-Loading the Stove....................................22 This appliance is designed and Ashes must be disposed in a Emissions and Efficiency................................6 approved for the burning of cord metal container with a tight lid Planning the Installation..................................7 Overnight Bum...............................................22 wood only. Do not attempt to © and placed on a non- Normal Operating Sounds............................22 burn an other t of fuel other combustible surface well away Additional Accessories Needed for Installation.....7 Hints for Bumina...........................................23 - than Cord wood in this from the home or structure. Additional Requirements for Canada....................7 Selecting Wood..............................................23 appliance,it will void all Fireplace Requirements..................................8 Why Dry Wood is Ke warranties and safety listings. Fireplace Altered Tag.......................................8 Wood Cutting and Storage..................................23 Insert Placement Requirements.....................9 Troubleshooting.............................................24 Hearth Reciuirements.....................................10 Daily Maintenance(while stove is in use) 25 Do not touch the appliance while Keep furniture,drapes,curtains, USA....................................................................10 Remove Ash(if necessary).................................25 it is hot and educate all children wood,paper,and other CANADA.............................................................10 Clean the Glass(if necessary)............................25 of the danger of li high- combustibles a minimum of 36" temperature appliance. Young away from the front of the Mantel Requirements.....................................10 Monthly Maintenance(while appliance is in children should be supervised 6' appliance. Masonry Fireplace Requirements................11 use)..................................................................26 when they are in the same room Zero-Clearance(Metal)Fireplace Door and Glass Inspection..................................26 as the appliance. Zero-Clearance arancents......etal....................................11 Door Latch Adjustment.......................................26 Creosote-Formation and Need for Removal.....26 Drafting Performance....................................11 Yearly aintenance...... Insert Rollers..................................................12 This appliance must be properly Contact your local building Touch-up Paint..........................r(if..ppli......e).27 installed to prevent the officials to obtain a permit and Leveling Bo/t Installation...............................12 Cleaning the Air Duct and Blower(if applicable).27 P p possibility of a house fire. The information on any installation Fettle Installation. Firebrick and Baffle Inspection............................27 instructions must be strictly restrictions or inspection Flue Installation..............................................13 Cleaning the Catalytic Combustor.......................28 adhered to. Do not use Ok requirements in your area. Sealing the Flue to the Insert..............................13 Door Parts.......................................................29 makeshift methods or Notify your insurance company Surround Panel Installation..........................14 Replacing the Glass............................................29 compromise in the installation. of this appliance as well. Face Installation.. 14 Replacing the Door Gasket.................................29 Re-Routing the Electrical Cord to the Left Blower and Electrical Parts..........................30 Side..................................................................15 Firebox Parts..................................................31 Inspect the chimney connector Safety Notice..................................................16 Baffle Parts.........................................................31 and chimney at least twice This appliance must be Baffle Removal....................................................31 monthly and clean if necessary. Before Your First Fire....................................16 O connected to a listed high Combustor..........................................................31 Creosote may build up and Type temperature UL 103 HT Verify the Installation...........................................16 Clay P ( ) Curing the Paint..................................................16 Air Tube Removal&Replacement...............32 cause a house fire. HT Liner residential type chimney or an Over-Firing the Stove..........................................16 Brick Removal&Replacement...........................33 Do not Connect this appliance to approved masonry chimney with Catalytic Combustor Temperature Probe any chimney serving another a standard clay tile,or stainless Opening the Door...........................................17 appliance. steel liner. Opening the Door................................................17 Installation Instructions................................34 Closing the Door.................................................17 GreenStartTM Igniter—Firebrick and Housing Bypass Operation..........................................18 Installation......................................................35 .. Catalytic Combustor—Use and Cleaning....19 Listing Label........................................................39 ©Travis Industries 100-01273 4111118 ©Travis Industries 100-01273 4111118 Safety Precautions 5 6 Stove Installation (for qualified installers only) Never try to repair or replace any part of this appliance unless Do not place clothing or other Installation Options Features instructions are given in this flammable items on or near this manual. All other work must be I' appliance. Masonry Fireplace Insert • EPA Phase II Approved done by a trained technician. Zero-Clearance(Metal)Fireplace Insert . 3 Cubic Foot Firebox Volume • Single Air Control • Accepts Logs Up to 24"Long • Steel Plate Construction(Up to 5/16") Allow the appliance to cool Do not make any changes or . Heavy Duty Refractory Firebrick before carrying out any modifications to an existing Standard High-Tech Blower maintenance or cleaning. masonry fireplace or chimney to Heating Specifications install this appliance. Approximate Maximum Heating Capacity(in square feet)' 1,500 to 2,500 Do not make any changes to the Maximum Bum Time Up to 12 Hours appliance to increase combustion air. 'Heating capacity will vary depending on the home's floor plan,degree of insulation,and the outside temperature. It is also affected by the quality and moisture level of the fuel. Maintain the door and glass seal Dimensions and keep them in good Over-firing the appliance may condition. cause a house fire. If a unit or 6"(153.m)Die. \\ Do not operate this heater with chimney connector glows,you 530 Lbs.(236 Kg) broken or missing glass. are over-firing. Avoid placing wood against the / 31"788.m glass when loading. Do not issmm slam the door or strike the glass. 20.7 528. / Do not throw this manual away. Do not use agrate OF other / This This manual has important device to elevate the fire off of Manual operating and maintenance the firebox floor. Bum the fire instructions that you will need at directly on the bricks. / a later time. Always follow the instructions in this manual. 22" 559mm 23.5" 597mm Travis Industries,Inc.grants no warranty,implied or stated,for the installation or a maintenance of your zasmm appliance,and assumes no 0 responsibility of any 19• consequential damage(s). \ /ae3mm Figure 1 (a)Measure clearances from base of insert (b)Fireplace Opening Emissions and Efficiency 0.58 Grams per Hour(EPA Phase II Approved) 80.3%Efficiency(13415—EPA) Tested for efficiency using B415.1-10 using the HHV for the test fuel heating value. ©Travis Industries 100-01273 4111118 ©Travis Industries 100-01273 4111118 Fireplace SAFETY NOTICE: Fireplace Requirements Please read this entire manual before you install and use your new room heater. Failure to Figure 2 shows the minimum size requirements for the type of fireplace used. follow instructions may result in properly damage,bodily injury,or even death. Contact local building or fire officials about restrictions and installation inspection requirements in \ Minimum Fireplace Size yourarea. a Height front 23.5" 597mm Planning the Installation co b Height rear 22"559mm a �6 c Width front 33°'839mm' We suggest that you have an authorized Travis Industries dealer install your fireplace insert. If you Mibi install the fireplace insert yourself,your authorized dealer should review your installation plans. eMe d Width rear 20.75" 528mm Check with local building officials for any permits required for installation of this fireplace insert and \i Orsi a Depth 19" 483mm notify your insurance company before proceeding with installation. t f Hearth Depth 18""458mm" Non h NOTE:Base of insert must be a Preparation for Installation Coin minimum t"above combustible floor • Check for damage to the exterior of the fireplace insert(dents should be reported,scratches can be j j beSribie surfaces(carpet,wood etc.). See fixed by applying touch-up paint). Reoi� Hearth Requirements'for further details. • Check the interior of the firebox(replace cracked firebrick and make sure baffle is in place). a Hearth Width 47" 1093mm The fireplace insert can be lightened by removing the firebricks and baffle(pg.33)-replace before d operation. h FacingWidth 42" 1194mm Additional Accessories Needed for Installation c jig)/ I Facing Height Above Base of Insert 37" 940mm • Non•Co� ��`-� I j Mantel Height Above Base of Insert 41" 1042mm Face • Surround Panels(see page14) b�sgbi Additional Requirements for Canada g eyeeiUi • Do not remove bricks or mortar from existing fireplace. f • This fireplace insert must be installed with a continuous chimney liner of 6°diameter extending from the fireplace insert to the top of the chimney. The chimney liner must conform to the Class 3 requirements of CAN/ULC-S635,Standard for Lining Systems for Existing Masonry or Factory-Built Chimneys and Vents,or CAN/ULC-S640,Standard for Lining Systems for New Masonry Chimneys. Figure 2 'Includes 2"(61mm)for power cord installation. In the US,a 16"(407mm)hearth may be used if base of insert is 2" • Permanently seal any opening between the masonry of the fireplace and the facing masonry. (sl mm)above combustible floor surfaces(carpet,wood,etc.). • Fireplace insert,or surround panels,may be removed to inspect fireplace insert and fireplace. • Lock existing dampers in the open position. Fireplace Altered Tag Attach the"This fireplace has been altered..."plate to the fireplace(use two screws or other suitable method). You may wish to place it in a location where it will be covered by the surround panels. ©Travis Industries 100-01273 4111118 ©Travis Industries 100-01273 4111118 Fireplace Insert Installation (for qualified installers only) 10 Fireplace Insert Installation (for qualified installers only) Insert Placement Requirements Hearth Requirements • The insert must be placed so that no combustibles are within,or can swing within(e.g.drapes, When installing into a masonry fireplace,the hearth must meet Uniform Building Code(UBC)standards. doors),36"must be )of the front of the insert(Figure 3"q"). A UBC hearth extending 16"(407mm)in front of the fireplace insert must have a surface 2"(51 mm) above the surrounding combustible floor.(Canada)A UBC hearth extending 18"(458mm)in front of the • Insert and hearth must be installed on a level,secure floor fireplace insert must have a surface 1"(25mm)above the surrounding combustible floor.The surface of a • The minimum clearances,facing,and hearth requirements in Figure 3 must be met. UBC hearth may be raised by applying any noncombustible material.A hearth extending 20"(508mm)or more has no height requirement. Minimum Clearances USA k Sidewall 10.5"267mm When installing into a zero-clearance fireplace,the hearth must extend 16"(407mm)to the front and 8" I Side Facing noncombustible 5.5" 140mm (204mm)to the sides of the insert.The surface of the hearth must be 2"(51 mm)above the surrounding combustible floor and the hearth must provide and R-value(thermal resistance)of 2.38 or greater. m Top Facing non-combustible 37"940mm If the insert is a minimum 7"(178mm)above the combustible floor(carpet,wood,etc.)the hearth must n Mantel combustible 41" 1042mm extend 16"(407mm)in front and 8"(204mm)on both sides of the insert. Hearth must be non-combustible (cement board,tile,etc.).No R-value(thermal resistance)is required. o Front Hearth 18"`458mm` CANADA NOTE:Base of insert must be a minimum 1"above combustible floor surfaces(carpet,wood,etc.). See When installing into a zero-clearance fireplace,the hearth must extend 18"(458mm)to the front and 8" "Hearth Requirements"for further details. (204mm)to the sides of the insert.The surface of the hearth must be 1"(25mm)above the surrounding Side Hearth 8"204mm combustible floor and the hearth must provide and R-value(thermal resistance)of 2.38 or greater. If the insert is a minimum 7"(178mm)above the combustible floor(carpet,wood,etc.)the hearth must Front of Insert 36" 915mm extend 18"(458mm)in front and 8"(204mm)on both sides of the insert. Hearth must be non-combustible r Mantel Breastplate max.1"26mm thick 37"940mm (cement board,tile,etc.).No R-value(thermal resistance)is required. s Mantel Column max.8"204mm dee 5.5" 140mm x Extension Onto Hearth from front edge of insert0"Omm `In the US,a 16"(407mm)hearth may be used if base of insert is 2"(51 mm)above combustible floor surfaces(carpet,wood,etc.). See"Hearth Requirements"for full details. -Combustible HearthNon-Combustible Hearth Non I #� t (nic Cement Board,etc.) (min.R-Value 2.38) Min.1•(25mm) - � 1,yyg5�� l'} Min.7 Combus8ble hMm.18'( ComWstiblo USA Min.16'(407mm) Flooring Flooding Canada Min.18'(458mm) y� a Da Mantel Requirements Side v n r a�Tga • See minimum mantel clearances below. WallMax.1" I� m 26mm Max.1T(305mm) Max.1•(25mm) X (,Min.dt" , 042mm) l � I Maximum Martel Depth(b) Min.3T' MaNet He M F 4� (940mm) Above Saw of Filowe 39• 38• Figure$ Baw o/Inwd'--I 3r(940,nm) ©Travis Industries 100-01273 4111118 ©Travis Industries 100-01273 4111118 InstallationFireplace Insert qualified Masonry Fireplace Requirements Insert Rollers • Must utilize a positive connection(full reline) • Entire fireplace,including chimney,must be clean and undamaged. Any damage must be repaired Two rollers are built into the back edge of the insert. This prior to installation of the insert. allows the insert to be rolled into position by lifting the front • Chimney height:15'(4.5M)minimum;33'(1 OM)maximum(measured from base of insert). of the insert and pushing it into position(see Figure 5). • Entire fireplace,including chimney,must meet local building requirements. • The fireplace insert must be placed on a masonry hearth built to UBC standards. Zero-Clearance(Metal)Fireplace Requirements • Must utilize a positive connection(full reline). • Must be manufactured by one of the following manufacturers: Figure 6 Marco •Majestic •Heatilator •Preway •Tempco •Superior Heat N Glo •Lennox •Martin •Monesson Leveling Bolt Installation • Entire fireplace,including chimney,must be clean and undamaged. Any damage must be repaired MASONRY NOTE:Place a metal plate below the prior to installation of the insert. bolts on masonry fireplaces to prevent damage to the • Entire fireplace,including chimney,must meet local building requirements. floor brick. Two leveling bolts are pre-installed on the insert to Q • Chimney height:15'(4.5M)minimum;33'(10M)maximum(measured from base of insert). Minimum allow for proper leveling within the fireplace. To 0 y cross section:28.65 square inches(18626 sq.mm). access the bolts,remove the back comer firebricks • The damper("A")and grate("B")must be removed(see Figure 4). The smoke shelf("C"),internal and cover plates"a'and"b").The bolts are pre- baffles("D"),screen("E"),and metal or glass doors("F")may be removed(if applicable). The threaded to a weld-nut on the base of the insert. Use masonry lining(masonry sides,floor,etc.-"G"),insulation("H"),and any structured rigid frame a 3/4"socket wrench to screw the bolts down members(metal sides,floor,door frame,face of the fireplace etc.—"I")may not be removed or (clockwise)until the insert is level(see'c"). _ altered. SEALING THE COVER PLATE:We recommend sealing the cover plate with furnace cement(place on underside of cover plate). BOLT LENGTH:The included bolts allow C A approximately 1"of rise. If additional rise is required, F use a longer 1/2-13 thread bolt. Make sure the additional bolt length does not interfere with the cover D plate. E O Figure 6 Fettle Installation Figure 4 The fettle is designed to prevent ash from spilling out of the firebox opening.It is held in place with two tabs Drafting Performance and slots at the front of the firebox(see pictures below).The fettle is optional and may be removed if desired. This appliance relies upon natural draft to operate. External forces,such as wind,barometric pressure, topography,or factors of the home(negative pressure from exhaust fans,chimneys,air infiltration,etc.), may adversely affect draft. Travis Industries cannot be responsible for external forces leading to less than optimal performance. f v ©Travis Industries 100-01273 4111118 ©Travis Industries 100-01273 4111118 Fireplace Fireplace Flue Installation Surround Panel Installation RLH Chim-Flex Starter Sections Width Height Part# Fr,e(ne,aie o,�ro�a, i�nedea��me ow�wrs De=x e,a RLH manufactures starter Standard Size 42" 32-1/2" 96100392 uvea ree ae�xem arta e..een- sections in straight or d,ongedee+u.edw.e angled configurations to 1. Before installing,the insert should be in place with the flue attached.Attach the brackets as �,,,,,, teww,e We,We,nNe Bn F'�&^�•� suit your application. - s shown below,using the screws included in the hardware pack with the insert.Make sure the They are secured from t inside the firebox,making p brackets are flush with the front of the convection chamber. installation much easier. �-� Contact RLH for additional details: , Flue ODenmq y www.chim-fiez.com Sealing the Flue to the Insert This insert utilizes a catalytic combustor to increase efficiency and decrease emissions. This increases the air resistance inside the firebox,making the flue connection especially important.To insure proper draft,and to prevent smoke spillage during re-loading,it is crucial for the flue to be sealed with fireplace cement. If an adapter is used,both joints to the liner and to the insert must be sealed.Use a generous amount of fireplace cement at every connection(where the flue connects to the insert and at every joint). In addition,we recommend using noncombustible fiberglass insulation to seal the fireplace enclosure. By sealing the top and bottom of the chimney,and the surround panels,you will be ensuring outside air is 2. Attach the surround panel as shown below. not pulled into the chimney. Install a non-combustible cover plate to prevent water Cap(prevents water from from entering the chimney - entering) Flue Liner The liner must be stainless steel connector or flexible vent. Follow the liner manufacturer's insturctions for installation and — support. / — 41 Combustible Mantle Airtight Insulated Clean-Out ..,, = Remove damper or wire it open See the section"Insertaco — We recommend using non-combustible HINT: When installing the panel,route the wires through the notch on the bottom of Placement Requirements"for FG e — fiberglass insulation to seal the to the panel(either side). minimum clearances and enclosure(chimney top and bottom,and hearth required. surround panels) —_- Face Installation I I — Seal the flue connection to the insert There are several face options available for this fireplace insert. Refer to the instructions included with your face. ©Travis Industries 100-01273 4111118 ©Travis Industries 100-01273 4111118 Fireplace Insert-installation (for qualified installers only) 15 16 0 ting Your Appliance Re-Routing the Electrical Cord to the Left Side Safety Notice The power cord is connected to the right side of the insert when it leaves the factory. It may be re-routed If this appliance is not properly installed,a house fire may result.For your safety,follow the installation to the left side following the directions below. Do this procedure before installing the surround panels. A directions.Contact local building or fire officials about restrictions and installation inspection • Disconnect the Molex connector and remove the power cord following the directions below. requirements in your area. Disconnect the molez connector leading from the power cord. A Read and follow all of the warnings on pages 4 and 5 of this manual. Rheostat Wires �® Before Your First Fire Yl Verify the Installation Power Before starting the stove,verify that the stove is properly installed and all of the requirements in this Cord manual have been followed. Keep all flammable materials 36"away from the front of the stove(drapes,furniture,clothing,etc.). Use pliers to compress the strain relief Curing the Paint 2 to 4 hours from the top and bottom while pulling it '11- out out of the hole in the side of the insert. This heater uses a heat-activated paint that will emit some fumes while O 4 NOTE:headderthrionaknockout is ,�� — starting the first fire. Open doors and windows to the room to vent these provided d using the!men wiring kit. fumes. This typically lasts two to four hours. You may also notice oil burning Route os powrough he one hole. off of the interior of the heater. This rust-stopping agent will soon dissipate. the rheostat through the other. Leave the rheostat Door Gasket-The door gasket might adhere to the paint on the front of the wires in place. heater. Leave the door slightly ajar for the first fire and be careful when Make sure the Dower eortl is opening the door after the first fire. disconnected prior to conductina these steps. Over-Firing the Stove This stove was designed to operate at a high temperature. But due to differences in vent configuration, Remove the power cord. fuel,and draft,this appliance can be operated at an excessive temperature. If the stove top or other area starts to glow red,you are over-firing the stove.Shut the air control down to low and allow the stove to • Connect the power cord to the left side following the directions below. cool before proceeding. Attach the molex connector on the Over-firing may lead to damage of plated surfaces. If any portion of the heater glows red,it is power cord to the molex connector A considered over-firing and will void the warranty. on the left side of the insert. Power Cord Re-attach the strain relief to the left side(use 0 pliers to compress the strain relief from the top and bottom while pushing it into the hole). Remove the button plug from the left side. ©Travis Industries 100-01273 4111118 ©Travis Industries 101101273 4111118 ----Operafing Your Appliance 17 18 Operating Your Appliance... Opening the Door Bypass Operation The door becomes hot during use. Use a glove to open the door if the handle is hot. The bypass controls the flow of smoke inside the heater. When pulled out,smoke goes directly up the flue,creating more draft. When pushed in,the smoke goes around the baffle,utilizing the secondary 0 To prevent smoke from entering the room,open the bypass before opening the door(see following page combustion and making the heater more efficient. for directions). You can also open the door a small amount and let air enter the firebox. When starting or re-loading,pull the bypass out,if necessary. • During normal operation,push the bypass in. Opening the Door Bypass Pulled Out Use the included pull tool Used for starting and re-loading to operate the bypass rod O o Bypass Pushed In Used for normal operation Closing the Door a I O tpO i f ©Travis Industries 100-01273 4111118 ©Travis Industries 100-01273 4111118 Operating • •• 1 Operating • Appliance Catalytic Combustor-Use and Cleaning Starting a Fire This heater uses a catalytic combustor to improve efficiency and reduce emissions. To work at Since the dawn of time man has debated the best way to start afire. Some use the boy-scout'Yee-pee" its optimum,the combustor must be kept free of excessive ash. If the heater becomes sluggish some prefer the'Yic4ac-toe"stack. Either way,review the hints and warnings below to ensure proper fire when the bypass is dosed,flyash maybe building upon the combustor. Seethe directions starting. below to inspect and clean the combustor with the included brush. . Make sure the air control is pushed in and the by-pass pulled out. If additional air is needed,open the doors 1/4"during the first five minutes of start-up. �rK Inspecting&Cleaning the Combustor The combustor becomes very hot during operation. Let the heater cool before cleaning the combustor. The combustor is located directly above ` _the firebox opening. Make sure the square openings are open for air to pass 1 • ■III■ilul�llil • through. If ash is accumulating,use the brush to Gear off visible flyash. Never use gasoline,gasoline-type lantern fuel,kerosene,charcoal lighter fluid,or similar liquids to start NOTE:To thoroughly dean the _ /A or"freshen up"a fire in this stove. Keep all such liquids well away from the stove while it is in use. combustor,use an ash vacuum to pull flyash from the combustor(see page 28). ,moi DO NOT USE CHEMICALS OR FLUIDS TO START THE FIRE. DO NOT BURN GARBAGE OR ✓ FLAMMABLE FLUIDS SUCH AS GASOLINE,NAPHTHA OR ENGINE OIL. Do not place such fuel within space heater installation clearances or within the space required for charging and ash removal. If using a fire-starter,use only products specifically designed for stoves-follow the manufacturers instructions carefully. HOT WHILE IN OPERATION. KEEP CHILDREN,CLOTHING AND FURNITURE AWAY. CONTACT MAY CAUSE SKIN BURNS. WIf the smoke does not pass up the chimney,ball up one sheet of newspaper,place it in the center of the firebox and light it. This should start the chimney drafting(this eliminates"cold air blockage"). 0 Use plenty of kindling to ensure the stove reaches a proper temperature. Once the kindling is burning ' * - — Y— 's rapidly,place a few larger pieces of wood onto the fire. Combustor Starting a"Top-Down Fire" " .; One particularly successful method for starting a fire is to +.. - +r+rG•ai stack several large pieces of wood in the center of the stove (see the illustration to the right). Then place a several wads 4, of newspaper in the center with kindling on top. When you light the newspaper this"top-down"fire will burn its way to the center,igniting the larger pieces. With some practice, this method should work for you. —- ©Travis Industries 100-01273 4111118 0 Travis Industries 100-01273 4111118 Operating Your Appliance 21 22 Operating Your Appliance Adjusting the Burn Rate Blower Operation Use the air control slider to control the bum rate of the stove. See the illustration below for details. The blower will tum on once the stove is up to temperature. This is typically 15 to 30 minutes after starting the fire. Follow the directions below to alter the blower speed. Use the air control to change the bum rate. a The blower rheostat dial may look different. It does operate in the same fashion. OFF HIGH LOW Tam the dial all the The high poadior li the mm me diel all way couNer<lockwtu my courser<lockwiae, --y until h.kk—If. without clickiip oR. clockvAu. Low Bum High Bum O (air control closed) (air control open) //i y f.. v- 0 The blower may be used to affect heat output(i.e.:to reduce heat output,tum the blower down). ARoute the power cord in a location where it will not come in contact with the appliance or become hot. Re-Loading the Stove Follow the directions below to minimize smoke spillage while re-loading the stove. 1 Open the air control all the way(push it in). Open the bypass;pull it out If necessary. 2 Open the door slightly. Let airflow inside the firebox stabilize before opening the doors fully. 3 Load wood onto the fire. Overnight Burn Follow the steps below to achieve an overnight burn. Approximate Air Control Settings: 1 Move the air control to high burn and let the stove become hot(burn for approximately 15 minutes). Overnight Burn Pulled fully out 2 Load as much wood as possible. Use large pieces if possible. Medium Bum Pulled fully out to 1/16"In 3 Let the stove bum on high for 15 minutes to keep the stove hot,and then turn the air control to Medium High Bum 1/16"to 11/64"In low. High Bum 11/64"to Pushed All the Way In 4 In the morning the stove should still be hot,with embers in the coal bed. Stir the coals and load small pieces of wood to re-ignite the fire,if desired. The air control becomes hot during operation-use gloves or a tool to prevent burns. Differences in chimney height and draft may lower overall bum times. Creaks and Clicks: 0 The air control may take several minutes to influence the bum rate. When making adjustments,you Normal Operating Sounds The steel may creak or click when the stove heats up may wish to let the stove bum for 10 minutes to gauge performance. and cools down-this is nomlal. Ash Removal Blower Sounds: The blower will make a slight"humm"as it 0 Ashes should be placed in a metal container with a tight fitting lid.The closed container of ashes pushes air through the stove. should be placed on a noncombustible floor or on the ground,away from all combustible materials, ASHES pending final disposal.If the ashes are disposed of by burial in soil or otherwise locally dispersed, they should be retained in the closed container until all Enders have thoroughly cooled. ©Travis Industries 100-01273 4111118 ©Travis Industries 100-01273 4111118 ----—---Operating Your Appliance 23 24 Operating Your Appliance Hints for Burning Troubleshooting • Get the appliance hot before adjusting to low bum Problem Possible Cause • Use smaller pieces of wood during start-up and high burns to increase temperature Smoke Enters Room During Open the bypass(pg.18). • Use larger pieces of wood for overnight or sustained bums Start-Up Open the air control(pg.21). • Stack the wood tightly together to establish a longer burn Cold Air Blockage-burn a piece of newspaper to • Leave a bed of ashes(1f2"deep)to allow for longer burns establish a draft. • Be considerate of neighbors&the environment:bum dry wood only If the flame is not getting enough air,a small crack in • Burn small,intense fires instead of large,slow burning fires when possible the door is all that is needed. • Learn your appliance's operating characteristics to obtain optimum performance Kindling Does Not Start-Fire Open the bypass(pg.18). Selecting Wood Smolders Open the air control(pg.21). g Not enough starter paper-use additional newspaper if • Dry Wood is Key—moisture Wet Dir necessary. content should be less than 25% Wood /Vy Wood If the flame is not getting enough air,a small crack in • Dry wood burns hot,emits less Leads Leach the door is all that is needed. smoke and creates less creosote. �TO J 1.TO Smoke Enters Room While Re- Open the bypass before opening the door(pg.18). • TestingWood Moisture �V7 LoadingOpen the air control before opening the door(pg.21). • Split wood stored in a dry area will . Let the air stabilize before fully opening the door. be fully dry within a year. This Less MoreThen open the door approximately 1 inch. Let air go 1 1` insures dry wood. If purchasing HeatHeat °r ,) into the firebox for a few seconds. Once the smoke wood for immediate use,test the ;Z+n Lead. T. appears to be flowing up the chimney consistently, wood with a moisture meter. Some open the door. experienced wood burners can Insufficient:•.< cient Draft-Chimney height and outside measure wood moisture by conditions can negatively affect draft. In these cases a knocking pieces together and More Smoke Less Smoke small amount of smoke may enter the home. Adding listening for a clear"knock"and not and Creosote and Creosote more piping or a draft-inducing cap may help. a"thud". Chimney liner joints are not properly sealed at the insert connection. Why Dry Wood is Key Stove Does Not Burn Hot Enough • Wood is Wet-see the section"Selecting Wood"on page 23 for details on wood. Wet wood,when burned,must release water stored within the wood. This cools the fire,creates Make sure the air control is all the way open. Slide the creosote,and hampers a complete burn. Ask any experienced wood burner and he or she will agree:dry control back and forth to insure the control is not stuck. wood is crucial to good performance. Insufficient Draft-Chimney height and outside Wood Cutting and Storage conditions can negatively affect draft. In these cases Cut wood to length and Store the wood off theQ gqround in a / the fire may bum slowly. Adding more piping or a chop into quarters. covered area. Allow for airflow / Air Flow draft-inducing cap may help. around the wood to dry the wood. Blower Does Not Run Stove is Not Up to Temperature-This is normal. The blower will come on when the stove is hot-usually 15 to 30 minutes. _ Electricity Is Cut to the Blower-Check the household hbreaker or fuse to make sure it is operable. Stove Does Not Burn Long • Depending upon wood,draft,and other factors,the Enough burn time may be shorter then stated. Make sure the doors are sealing and not allowing air into the firebox- O C A6 1 See the section"Door and Glass Inspection"on page 26 for details. Fur Flow Check the ash bed for coals. Often,coals are still Air Flow glowing under a slight bed of flyash. By raking these into a pile you can re-start your stove quickly. ©Travis Industries 100-01273 4111118 ©Travis Industries 100-01273 4111118 Maintaining Your Appliance 25 26 Maintaining Your Appliance Must replace components with equipment equivalent to the original or approved by the manufacturer. Monthly Maintenance(while appliance is in use) AFailure to properly maintain and inspect your appliance may reduce the performance and fife of the Make sure the appliance has fully cooled prior to conducting service. appliance,void your warranty,and create a fire hazard. AEstablish a routine for the fuel,wood burner and firing technique. Check daily for creosote build-up until Door and Glass Inspection experience shows how often you need to clean to be safe. Be aware that the hotter the fire the less creosote is deposited,and weekly cleaning may be necessary in mild weather even though monthly � The door can be lifted off the hinges if extensive repairs are conducted. cleaning may be enough in the coldest months. Contact your local municipal or provincial fire authority for information on how to handle a chimney fire. Have a clearly understood plan to handle a chimney fire. The door must form a seal to the firebox for the stove to work correctly. Inspect the door gasket as shown below. Daily Maintenance(while stove is in use) u.a RTv high Remove Ash(if necessary) "—..K . adhere a.y w•.. • Ash removal is not required once it builds up.1/2"to 1"of ash may be desirable because it slows the burn rate. Generally,remove ash once it has built up over 1". Follow the directions below to remove ash. am.III—I.m g.d. replace It... 1 Let the stove cool completely(at least two hours after the last coal has extinguished). 'R°P,a..—P„ I., 2 Place a cloth or cardboard protector over the hearth to catch ash and protect against ""��' s•.reraynay.d.rcnr.ao-mr./� scratching. s• °`"°"°°°r•PWcaa. 3 Open the doors and scoop the ash into a metal container with a tight fitting lid.The closed container of ashes should be placed on a noncombustible floor or on theDoor Latch Adjustment ASHES ground,away from all combustible materials,pending final disposal. The door latch should pull the door against the face of the stove(but not so tight as to not allow full Improperly disposed ashes lead to fires. Hot ashes placed in cardboard boxes,dumped in back yards, handle rotation). If the latch requires adjustment,follow the directions below. or stored in garages,are recipes for disaster. aWood-burning stoves are inherently dirty. During cleaning have a vacuum ready to catch spilled ash Remove the face. Loosen the bottom nut (make sure ash is entirely extinguished). with a 7/16°wrench(see arrow to the right). Tap the bottom nut inwards,moving the door There are vacuum cleaners specifically made to remove ash(even if the ash is warm). Contact your catch inwards. Tighten the nut and test dealer for details. operation. You may need to repeat this process,either moving the nut inwards or Door Handle Clean the Glass(if necessary) outwards,until the door catch is in the correct t This appliance has an airwash to keep the glass clean. However,burning un-seasoned wood or burningposition. on lower burn rates leads to dirtier glass(especially on the sides). Do not clean glass with abrasive cleaners. Allow the stove to fully cool before cleaning. Apply glass cleaner or soapy water to the inside of the glass. Wipe with newspaper or a paper towel to clean. For stubborn creosote,dip a moist paper towel or newspaper in cold ash before cleaning. The Creosote-Formation and Need for Removal ash acts as a mild abrasive. When wood is burned slowly,it produces tar and other organic vapors,which combine with expelled moisture to form creosote. The creosote vapors condense in the relatively cool chimney flue of a slow- burning fire. As a result,creosote residue accumulates on the flue lining. When ignited,this creosote makes an extremely hot fire. The chimney and chimney connector should be inspected at least once every two months during the heating season to determine if a creosote buildup has occurred. If creosote has accumulated 1/8"(3mm),it should be removed to reduce the risk of a chimney fire. U If you are not certain of creosote inspection,contact your dealer or local chimney sweep for a full inspection. Excess creosote buildup may cause a chimney fire that may result in property damage, injury,or death. Operating this appliance continually at a low burn rate(air starvation)or using green(un-seasoned) The glass will develop a very slight haze over time. This is normal and will not affect viewing of the fire. /A wood will increase the formation of creosote. 0 Travis Industries 100-01273 4111118 ©Travis Industries 100-01273 4111118 Maintaining Your Appliance Appliance Yearly Maintenance Cleaning the Catalytic Combustor NOTE:Use an ash vacuum with brush attachment to clean the catalytic combustor. ® Make sure the appliance has fully cooled prior to conducting service. 1. With the stove fully cooled,insert the ash vacuum nozzle into the area directly above the door Touch-Up Paint opening. I Included with the owner's pack of this appliance e a can h le the appliance , paint. To touch up nicks or dulled paint,apply the paint while the appliance is ? , cool. Sand rusted or damaged areas before preparation(use 120-grit sandpaper). Clean and dry the area to prepare the surface. Wait at least one T°u Up a �� M•�' hour before starting the appliance. The touched up area will appear darker Paint p -;+• than the surrounding paint until it cures from heat. Curing will give off some :f fumes while curing—open windows to ventilate. : ' Cleaning the Air Duct and Blower(if applicable) _ Use a vacuum to clean the air ducts(channels). This prevents dust from burning and creating odors. The blower should be vacuumed every year to remove any buildup of dust,lint,etc. 2. Carefully place the brush surface of the nozzle over the catalytic combustor openings and remove any ash or debris.Take care to prevent damage to the catalytic combustor(the surface is fragile). ty Remove the face. Use a vacuum cleaner to remove any Pr debris or dust in the convection -7 , chamber or near the blower -- (WARNING:do not touch the blower blades). - - Firebrick and Baffle Inspection Use the illustration on page 30 as a reference for checking the following items. Make sure the appliance is cool before proceeding. Baffle-check the baffle plate along the ceiling of the firebox to make sure it is intact. Check the bypass assembly. Secondary Air Tubes-Check the air tubes to make sure they are intact and not severely deteriorated. Slight scaling or rusting of the metal is normal. Make sure the air tubes are secured correctly. Floor and Wall Firebricks-replace any severely damaged firebrick along the side or Floor of the firebox. ©Travis Industries 100-01273 4111118 ©Travis Industries 100-01273 4111118 Maintaining Your Appliance 29 30 Maintaining Your Appliance____ Door Parts Blower and Electrical Parts Rectangular Door AMake sure to unplug the appliance prior to conducting service. e � 5 � r O CR 2 ' 8 144 l� 8 O Arched DOOI ID# Descri tion PaR# ID# DescPart# 1 Left Blower 1 228-10069 2 Flight= 1 228-10070 3 4 Blower Grommets w Spacers 1 93005017 1 1 4 1 Rheostat w Nut&Washer I 1 j 25000302 9 5 Rheostat Knob 1 250-00369 6 Power Cord 1 25000316 7 1 Thermodisk 1 1 228-30050 0 7 2 \/ 4 8 3 ID# Descri tion Part# ID# Descd tion Part# 1 Gasket Cement 4 oz. 1 99900427 2 Door Gasket 3/S°z 80" 1 99900429 34 Gi swSaews Gaskets-Rett 1 250-02191 4 2 ClipGaskets 1 250-02182 5 Glass w Gasket—Rectangular 1 25002533 6 Glass Gasket 1/4'X 76" 1 250-02184 7 Handle Assembly 1 250-02196 8 Wood Handle w Screw 1 1 250-01305 9 Glass(w Gasket)—Arched 1 25002905 Replacing the Glass AThe glass must not contact the door retainer or glass clips directly. The glass gasket and glass clip gaskets insulate the glass to prevent cracking. Do not over-tighten the glass clips.Use only 5mm thick neo-ceramic glass. Lay the glass gasket in the door frame(cut off excess gasket). Place the glass on the gasket. Secure the glass clips to hold the glass in place(make sure the glass clip gaskets are in place). Replacing the Door Gasket The door gasket inserts into the outer groove of the door retainer. Stove gasket cement holds it in place. Before installing,remove any residual cement. Lay the gasket in place(start at the lower left comer)and cut off any excess gasket(do not stretch the gasket.The cement fully cures with heat from the stove. You may need to open and close the door repeatedly to get the gasket to seat fully. ©Travis Industries 100-01273 4111118 ©Travis Industries 100-01273 4111118 Maintaining Your Appliance Appliance Firebox Parts Air Tube Removal&Replacement 8 a Use penetrating oil(WD-40-or similar)on the bolts before removing them. Let the oil soak in for several minutes before attempting to remove the bolts. 7 WEW FROM TME FRONT VIEW FROM THE REAR 6 Ab Tube g00000 5 /� A'v cn.nnel / ar r"m eon ar cb• 1 Ir T.b. T—P eon a. in � 3 ' AIR TUBE REMOVAL t JIe'Wmncn L--Ibis bon 2 or 3 NON MwIM wMer of the air Nbe pin turns(tlo nat remove). mseds inN a hoN on tM air tube. f f P 2 Baffle Parts ID# Descri tion Part# ID# Descri ion Part# vtlm o"ban Nos.aee a••n wbe oaa t sec.Air Tubes w Pins all 3 1 98900245 2 Air Tube Pin w screw 3 250-02186 a siia out orme elr Mann•I. 3 Baffle 1 250-02490 1 4 1 Baffle Insulation 1 250-02494 5 C talytic Combustor with Gasket 1 1 1 250-02489 1 6 1 Bypass slider 1 1 250-02492 7 1 Damper Extension Rod 1 1 98900333 8 1 Yoke 1 1 1 250-02493 Baffle Removal 1 Remove the face to prevent damage. Remove the door(lift off hinges). 2 Remove the front two air tubes(see"Air Tube Removal&Replacement"on the following page). TUBE SIZING 3 Remove the baffle plate and insulation. T.pin w11 tn•n d—q.g.nom me.ir wb• Combustor 6..—Ywsbt.r ffi.tpb..gntly). Front Tube=27-7/8"709mm I Your combustor is available through an authorized Travis dealer.You can visually check the condition of Middle Tube=26"661 mm your combustor by opening the door and looking above the baffle with a flashlight.If there is visible ash Back Tube=21-1/4"540mm accumulation on the surface of your combustor it should be cleaned off with a soft bristled brush.If there is visible creosote buildup(tar substance)on the combustor,bum your stove on high and the creosote should bum off.If the creosote does not burn off your catalyst needs to be replaced.If the insert emits excessive smoke on medium and high burns your catalyst may need replacement. To remove the combustor first remove the baffle(see Baffle Removal),open the bypass and reach through the bypass hole and push out the combustor from the rear.The combustor is housed in a stainless steel frame;push on the left and right side edges of the combustor frame so that it slides out PNat ne a'v Nbe d.—.—d— evenly. .aa w.and•title naa ar P 9 9 m.•ir anaaaei as tn•appoaita sN.. evenly.If the combustor is pushed at a side angle it will not come out. ©Travis Industries 100-01273 4111118 ©Travis Industries 100-01273 4111118 I Maintaining Your Appliance 33 34 Optional Equipment Brick Removal&Replacement Catalytic Combustor Temperature Probe Installation Instructions Floor and Side Brick 1. Remove the button plug from the top of the heater as shown below. 1 4 5 O 1 ` 5 1 2. Use a center punch to mark the convection top location as shown below. 4 ;irk, 1 3. Drill a hole through the convection top.Make sure to use the correct drill bit size to allow for an air- 2 5 tight seal. 1 1 1 3 2 NOTE:"F"Denotes Full Size Brick(4-1/2"x 9") ID# Description Qty. Part ID# Description qty. Part# 4. Insert the temperature probe to location near the combustor as shown Wow. 1 Firebrick,Whole 8 251-00000 2 Cut Brick,9x2.197x.593 2 251-00071 3 Cut Brick,9x7.175x2.362 2 251-00070 4 Cut Brick,9x4 251-00003 5 Cut Brick,9x2-7/8 3 251-00066 Do not pry the brick-they chip and crack easily. Remove the floor bricks first. The side bricks are pinned in place by the floor firebrick. Clean the firebox prior to replacing the brick. Refer to the section"Baffle Removal'on page 31 for details on removing the baffle bricks. dig ©Travis Industries 100-01273 4111118 ©Travis Industries 100-01273 4111118 Optional E• • Optional E• • GreenStadm Igniter-Firebrick and Housing Installation 3. Replace the floor firebrick to complete the installation. This insert is compatible with the GreenStartT"automatic wood-stove igniter.This optional component uses a specialized firebrick and housing that are shipped with the insert.If you are using the igniter,install these components as shown below.The igniter is installed as shown in the instructions included with the igniter kit. ION- 4. Remove the cover and gasket using a 5116"nutdriver.See the photos below. f Igniter Firebrick Igniter Housing '' f HINT:If you are not using the igniter,store these components inside the fireplace cavity in case the homeowner later decides to install them. fI 1. Remove the two firebricks from the front left corner of the firebox. \ ■ t j J L . r 5. Install the housing as shown below. NOTE:The gasket's hole patterns are unique.The housing must be re-installed in the same configuration.If the holes are not aligned,rotate the gasket 90'. 2. Place the igniter firebrick as shown below. k. n ' Q ©Travis Industries 100-01273 4111118 ©Travis Industries 100-01273 4111118 Limited 7-Year Warranty 371 3 8 Limited 7 Year Warranty Register your warrant online at traviswarranty.com. Or,mail our warrant card to: CONDITIONS&EXCLUSIONS g y y y 1. This new appliance must be installed by a qualified installer.It must be installed,operated,and maintained at all times in accordance with TRAVIS INDUSTRIES,INC.,4800 Harbour Pointe Blvd.SW,Mukilteo,WA 98275. - the instructions in the Owners Manual.Any alteration,willful abuse,accident,neglect,or misuse of the product shall nullify this warranty. 2. This warranty is nontransferable,and is made to the ORIGINAL purchaser,provided that the purchase was made through an authorized TRAVIS INDUSTRIES,INC.warrants this appliance(appliance is defined as the equipment manufactured by Travis Industries, Travis dealer. Inc.)to be defect-free in material and workmanship to the original purchaser from the date of purchase as follows: 3. Discoloration and some minor expansion,contraction,or movement of certain parts and resulting noise,is normal and not a defect and, therefore,not covered under warranty. Check with your dealer in advance for any costs to you when arranging a warranty call. 4. This warranty does not cover misuse of the stove.Misuse includes over-firing(operation where the connector or stove may glow red)of this appliance can cause serious damage and will nullify this warranty.Misuse includes use of salt saturated wood,chemically treated wood,or Mileage or service charges are not covered by this warranty.This charge can vary from store to store. any fuel not recommended in the manual. --- -—-- - - 5. Damage to the stove due to improper break-in procedures(see manual for proper break in). Years 1&2-COVERAGE:PARTS&LABOR 6. The salt air environment of coastal areas or a high humidity environment can be corrosive to the castings.These conditions can be corrosive • Firebox Assembly: and can cause the cast iron to rust.This warranty does not cover any damage caused by a salt air or high humidity environment. Firebox,Baffle Supports,Air Tubes,Air Channels,Convection Chamber 7. Damage to the appliance while it is in transit is not covered by this warranty,but is subject to a claim against the common carrier. • DODf Assembly: 8. The warranty,as outlined within this document,does not apply to the chimney components or other non-Travis accessories used in conjunction y with the installation of this product.If in doubt as to the extent of this warranty,contact your authorized Travis retailer before installation. Cast Door,Latch Assembly,Glass Retainers 9. Travis Industries will not be responsible for inadequate performance caused by environmental conditions such as nearby trees,buildings,roof • Air Control Assembly tops,wind,hills or mountains or negative pressure or other influences from mechanical systems such as lumaces,fans,clothes dryers,etc. Slider Plate,Pressure Plate 10.Damage to the catalytic combustor due to mishandling,removal,cleaning,or other handling is not covered.Degradation of the combustor due to burning of anything other than natural cord wood is not covered.Burning of trash,garbage,artificial or paper logs, • Ceramic Glass gift wrappings,coal,lighter fluids,chemical starters,treated or painted wood,driftwood or chemical cleaners will void the combustor Glass(breakage from thermal shock) warranty.These items contain chemicals that may cause the combustor to become deactivated. • Catalytic Combustor a This Warranty is void if. a. The appliance has been operated in atmospheres contaminated by chlorine,fluorine or other damaging chemicals. Catalytic Combustor(see"Conditions and Exclusions"#10) b. The appliance is subject to submersion in water or prolonged periods of dampness or condensation. • Firebrick c. Any damage to the appliance,combustion chamber,heat exchanger or other components due to water,or weather damage which is Breakage from thermal shock the result of,but not limited to,improper chimneytvenfing installation. • Accessories 12.Exclusions to this Warranty include:injury,loss of use,damage,failure to function due to accident,negligence,misuse,improper installation, alteration or adjustment of the manufacturers settings of components,lack of proper and regular maintenance,damage incurred while the Legs,Pedestal,Blower appliance is in transit,alteration,or act of God. • Re-Installation Allowance 13.This warranty excludes damage caused by normal wear and tear,such as paint discoloration or chipping,worn or torn gasketing,chipped or In cases where heater must be removed from home for repairs,a partial cost of re-installation is covered cracked firebrick,etc.Also excluded is damage to the appliance caused by abuse,improper installation,modification of the appliance,or the (pre-authorization required) use of fuel other than that for which the appliance is configured(use cord wood only). 14.Damage to brass or plated surfaces caused by fingerprints,scratches,melted items,or other external sources left on the surfaces from the • One-Way Freight Allowance use of abrasive deaners is not covered in this warranty.Damage to the surfaces from over-firing(operation where the steel may glow red)is One-wa freight allowance on re-authorized repair done at facto is covered. not covered in this warranty. 15.TRAVIS INDUSTRIES,INC.is free of liability for any damages caused by the appliance,as well as inconvenience expenses and materials. Exclusions: Paint,Gasketing Incidental or consequential damages are not covered by this warranty.In some states,the exclusion of incidental or consequential damage may not apply. Years 3 THROUGH 5-COVERAGE:PARTS&LABOR 16.This warranty does not cover any loss or damage incurred by the use or removal of any component or apparatus to or from the Travis • Firebox Assembly: appliance without the express written permission of TRAVIS INDUSTRIES,INC.and bearing a TRAVIS INDUSTRIES,INC.label of Firebox,Baffle Supports,Air Tubes,Air Channels,Convection Chamber approval.This warranty does not cover a stove repaired by someone other than a Travis Industries authorized dealer. 17.Any statement or representation of Travis products and their performance contained in Travis advertising,packaging literature,or printed • Air Control Assembly material is not part of this warranty. Slider Plate,Pressure Plate 18.This warranty is automatically voided if the appliance's serial number has been removed or altered in anyway.If the appliance is used for • Catalytic Combustor commercial purposes,itis excluded from this warranty. Coverage for thermal crumbling and disintegration only 19.No dealer,distributor,or similar person has the authority to represent or warrant Travis products beyond the terms contained within this warranty.TRAVIS INDUSTRIES,INC.assumes no liability for such warranties or representations. • Door Assembly: 20.Travis Industries will not cover the cost of the removal or re-installation of hearths,facing,mantels,venting or other components. Cast Door,Latch Assembly,Glass Retainers 21.If for any reason any section of this warranty is declared invalid,the balance of the warranty remains in effect and all other clauses shall remain in effect. • One Way Freight Allowance One-way frei ht allowance on re-authorized repair done at facto is covered. 22.This warranty is the only warranty supplied by Travis Industries,Inc.,the manufacturer of the appliance.All other warranties,whether express or implied,are hereby expressly disclaimed and purchaser's recourse is expressly limited to the warranties set forth herein. Exclusions: Paint,Gasketing,Accessories(Legs,Pedestal,Panels,Blower),Glass,Firebrick,Re- IF WARRANTY SERVICE IS NEEDED: Installation Allowance 1. If you discover a problem that you believe is covered by this warranty,you MUST REPORT it to your Travis dealer WITHIN 30 DAYS,giving Years 6 THROUGH 7-COVERAGE PARTS them proof of purchase,the purchase date,and the model name and serial number. 2. Travis Industries has the option of either repairing or replacing the defective component. • Firebox Assembly: 3. If your dealer is unable to repair your appliances defect,he may process a warranty,claim through TRAVIS INDUSTRIES,INC., Firebox,Baffle Supports,Air Tubes,Air Channels,Convection Chamber inducing the name of the dealership where you purchased the appliance,a copy of your receipt showing the date of the appliance's • Air Control Assembly purchase,and the serial number on your appliance.At that time,you may be asked to ship your appliance,freight charges prepaid,to Slider Plate,Pressure Plate TRAVIS INDUSTRIES,INC.TRAVIS INDUSTRIES,INC.,at its option,will repair or replace,free of charge,your appliance if ft is found to be defective in material or workmanship within the time frame stated witliln this warranty.TRAVIS INDUSTRIES,INC.will return your • Door Assembly: appliance,freight charges(years 1 to 3)prepaid by TRAVIS INDUSTRIES,INC.,to your regional distributor,or dealership. Cast Door Latch Assembly,Glass Retainers 4.Check with your dealer in advance for any costs to you when arranging a warranty call.Mileage or service charges are not covered by this warranty.This charge can vary from store to store. EXCIuSi011S: Paint,Gastion Allowance, Accnce,O e- (Legs,Pedestal,Panels,Blower),Glass,Firebrick,Re- 5.Any appliance or part thereof that is repaired or replaced during the limited warranty period will be warranted under the terms of the Installation Allowance,One-Way Freight Allowance,Labor Charges limited warrantyfora period not to exceed the remaining term of the original limited warranty or six(6)months,whichever is longer. Page 1 of 2 Page 2 of 2 ©Travis Industries 100-01273 4111118 ©Travis Industries 100-01273 4111118 1 I Listing Information 39 1 4 � Listing Label Additional Accessories Needed for Installation.,7 Hearth Requirements.......................................10 Additional Requirements for Canada.................7 Heating Specifications.......................................6 DO NOT REMOVE THIS LABEL Adjusting the Bum Rate...................................21 Hints for Burning..............................................23 CONTACT LOCAL BUILDING OR FIRE OFFICIALS ABOUT INSTALLATION AND RESTRICTIONS IN YOUR AREA. Air Tube Removal&Replacement...................32 Important Information.............. 2 SUITABLE FOR USE IN FACTORY-BUILT Q.C.)FIREPLACES AND MASONRY FIREPLACES. Ash Removal....................................................21 Insert Placement Requirements........................9 Baffle Parts.......................................................31 Insert Rollers....................................................12 �` MODEL: SERIAL NO: Baffle Removal.................................................31 Installation Options............................................6 `ClV m LG FLUSH WOOD Before Your First Fire.......................................16 Introduction........................................................2 IN-tek with Hybrid-Fyre'" Blower and Electrical Parts..............................30 Listing Label.....................................................39 Repana.dMa31M5ls 1R7m, cwtaw4twilsAmac.aeaa Blower Operation.............................................22 Mantel Requirements.......................................10 Brick Removal&Replacement........................33 Masonry Fireplace Requirements....................11 CONFORMS TO UL STD 1482;CERTIFIED TO ULC STD 5628.1993 Bypass Operation.............................................18 Monthly Maintenance(while appliance is in use) Catalytic Combustor Temperature Probe .....................................................................26 FACTORY-BUILT(Z.C.)FIREPLACE OR MASONRY FIREPLACE INSTALLATION Installation Instructions.................................34 Normal Operating Sounds...............................22 Clean the Glass................................................25 Opening the Door.............................................17 3 M NTL Mlnimumcirmanceto Masonry Factory Built Cleaning the Air Duct and Blower....................27 Over-Firing the Stove.......................................16 �. combustiMesand xeann Fiepae D.c.lFireplace Cleaning theCatalytic omor................... Overnight Combustor Oi ht Burn.................................................22 N 1 LL� Requrmands Installations hatallad— w 1 m, A. 10.5In.1277mm T.5in./267mm Combustor........................................................31 Planning the Installation.....................................7 D c B. 5.5 in/140 mm 5.5'n.1140— Creosote-Formation and Need for Removal..26 Preparation for Installation.................................7 ,n I ✓+ 'C. 37 in.1940mm 37in./9/0mm n D. 41in/lo4zram nm./tazmm Curing the Paint...............................................16 Re-Loading the Stove......................................22 1;j I SE T �J B' ' •/•••E.Us 16 in.1407mm 16 in./4o7mm Daily Maintenance(while stove is in use)........25 Remove Ash....................................................25 'I"E.(IAI l8imlem sem 18 in.1458 mm Dimensions........................................................6 Replacing the Door Gasket..............................29 —F— . F 5 6in.1153mm filo./153mm E NOFFCOMBUSTIBLE F.cn 8in.IZ04mm em.1204mm Door and Glass Inspection...............................26 Replacing the Glass.........................................29 HEARTH 1 E%TENSION FIREPLACE FACING 'Fromthe base ofFireplace In— Door Latch Adjustment.....................................26 Re-Routing the Electrical Cord to the Left Side •'Nantmnbustibla hearth most be 1 in.I N mm above any combustible material. Door Parts........................................................29 .....................................................................15 A 16 in./407 mm non—lovatible heats must be 2 in./51 mm above any comhustiblematerial. Drafting Performance.......................................11 Safety Notice....................................................16 Faclory43uilt Q.C.)Fireplace installations require a fireplace chimney full reline.Fattory-Built Q.C.)Fireplace chiTv must have a minimum Emissions and Efficiency...................................6 Sealing the Flue to the Insert...........................13 cross-sectional area of 28.85 square inches/733 square mm.A non-combustible hearth Floor protection is also required that provides a thermal Face Installation...............................................14 Selecting Wood......................................... 23 resistance with an R value equal to 2.38 a greater(see chart above and I or owner's manual for required sizing details). Features.............................................................6 Starting a Fire..................................................20 Minimum 6 in./153 mm diameter Stainless Steel liner,full reline required. Fettle Installation..............................................12 Surround Panel Installation..............................14 In Canada;a Fireplace insert shall be installed with a continuous chimney liner extending from the fireplace insert to the top of the chimney.A chimney liner shall be tested for conformance with Class 3 requirements of CANAJLC-S635,Standardfor Lining Systems for Existing Masonry Firebox Parts....................................................31 Touch-Up Paint................................................27 rm Factory-Built Chimneys and Vents,or CANIULC-5640,Standard for Lining Systems for New Masonry Chimneys. Firebrick and Baffle Inspection.........................27 Troubleshooting...............................................24 PREVENT HOUSE FIRES-Install and use only in accordance with the manufacturer's installation and operating instructions.Contact your local Fireplace Altered Tag.........................................8 Verify the Installation.......................................16 building a rite officials about restrictions and installation inspection in your area.Do not connect this unit to a chimney Rue serving another Fireplace Requirements.....................................8 Wood Cutting and Storage..............................23 appliance. Flue Installation................................................13 Yearly Maintenance.........................................27 CAUTION:the co deer used it this appliance(part no.a coo 111)is fragile and men be handled carefully.Burning to metal foils,plastic. TM gamage,=diesel diesel oil will render the uta yst in the combus[er inactive.The performance and durability of the catalytic combuster has Green Start Igniter—Firebrick Installation.....35 ria been evaluated as part of the certification. Elecum,al Rating: 11SV,60 H41.8 Amps \, Mawbclun d by Blowers: 0228-100691228-10070 W TRAVIS INDUSTRIES,INC. Do nroute pnrd under or in front of appliance. j ra 48110 o p— and Bhul.SW Replace glassoNywOh Smm—and,or TRAVISINDUSTRIES Mldlmo.WA 98275 ceramic glass. HOUSE Of FIRE wwwtravlsproducts.— U.S.ENV]ONNENTAL PROTECTION AGENCY CRrdfwd to comply with July 1990 particulate emission standards. DATE OF MANUFACTURE ^� Made in U.S.0. 2■ ■ nods ©Travis Industries 100-01273 4111118 ©Travis Industries 100-01273 4111118 S A L E S O R D E R PAGE:1 THE STOVE SHOPPE PHONE#: (978)794-5354 DATE: 7/30/2014 25 INDIAN ROCK ROAD, ROUTE 11 CELL#: ORDER#: 12281 WINDHAM, NH 03087 ALT.#: CUSTOMER#: 131812 Phone#: (603)537-0555 P.O.#: CP: Steve B Fax#: (603)537-0556 TERMS: Cash LOCATION: 1 SALES TYPE: Work Order STATUS: Pending TAG#: TECH: John C BILL TO 131812 SHIP TO tod Labrie tod Labrie 25 Windsor In 25 Windsor In N Andover, MA N Andover, MA YEAR MFR I MODEL NUMBER DESCRIPTION VIN/SERIAL# MILEAGE/METER 1: INSTALL HYBRID-FYRE Tech: John C [ ] MFR PRODUCT NUMBER DESCRIPTION ORD SOLD B/O PRICE NET TOTAL **** LAB25 Install Wood Insert w/Full 1 0 $0.00 $0.00 $0.00 Liner ZFX 20ILKTX06301 Liner Kit, SS-6"x 30' No T 1 1 $853.25 $853.25 $853.25 w/A Type OLY ELLF-6/30 Liner, Elbow 30deg Fixed- 1 0 $61.72 $61.72 $61.72 6" ROC 6DP Damper Plate 6" 1 0 $44.95 $44.95 $44.95 LAB LABOR COST 6 Labor Cost for Install 1 0 $660.00 $660.00 $660.00 RUT 76C Silicon CLEAR High 1 0 $14.95 $14.95 $14.95 Heat10.3oz Cartridge LAB note 1 0 $0.00 $0.00 $0.00 ********NOTE********** LAB NOTE 1 These parts represent a 1 0 $0.00 $0.00 $0.00 typical install LAB NOTE 2 However other parts may be 1 0 $0.00 $0.00 $0.00 require. PER Permit Permit&Processing Fee 1 0 $125.00 $125.00 $125.00 TRV 99800177 Large Flush Wood 1 0 $3,009.00 $2,708.10 $2,708.10 Hybrid-Fyre Includes 4Pk S/N: 1404-002680 TRV 96400713 Faces,Arched Door Classic 1 0 $323.00 $290.70 $290.70 Arch Black TRV 96100392 Large Flush Wood 1 0 $161.00 $144.90 $144.90 Hybrid-Fyre Insert Pane **** CUSTOMER PICK-UP CUSTOMER PICK-UP 1 0 $0.00 $0.00 $0.00 ****NO SALES TAX**** Parts Job 1: $4,903.57 Subtotal Job 1: $4,903.57 Thank you for your business! TOTAL PARTS: $4,903.57 TOTAL LABOR: $0.00 SUBTOTAL: $4,903.57 TAX: $0.00 ORDER TOTAL: $4,903.57 7/30/2014 PMT AMEX:508407 $4,903.57 BALANCE REMAINING: $0.00 Pmt AMEX AUTH#:508407 $4,903.57 II Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 154473 Type: Private Corporation Expiration: 3/14/2015 Tr# 237113 MIS-BEC OF N.H. INC. KEN SZYMANSKY 25 INDIAN ROCK RD. SUITE 19 WINDHAM, NH 03087 Update Address and return card.Mark reason for change. Address [_1Renewal R Employment Lost Card SCA 1 e^; 20M-05/11 C?�/e�o��e�r�zo�uae�c�,(�a�'C�/l�ccs�zc�uJells Office of Consumer Affairs&Business Regulation License or registration valid for individul use only rME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: ;eegistration: 154473 Type: Office of Consumer Affairs and Business Regulation xpiration: 3/14/2015 Private Corporaticr: 10 Park Plaza-Suite 5170 . .•y Boston,MA 02116 MIS-BEC OF N.H. INC. KEN SZYMANSKY 25 INDIAN ROCK RD. SUITE 19 WINDHAM, NH 03087 Undersecretary Not valid without signature Q .� Massachusetts -Department of Public Safety state New, ampshire Board of Building Regulations and Standards ` GAS FITTE yLICEN_ Construction Supervisor License: CS-096606 NAME: KENNETH Y ANSKY KEN T SZYMANSAY ., ' 1 '% ENDORSEMENTS"', 27 TICKLEFrLNCY LANs DATE ISSUED' 01/09/2 4 a SALEM NH 03079 DATE EXP ES: 02/29/201 Expiration LICENS #: GF0700998 Commissioner 02/25/2016 ,acc�fzo CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) `—� 1/3/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les)must be endorsed. If SUBROGATION IS WAIVED, subject to --'nrms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the c icate holder in lieu of such endorsement(s). PRODUCER CONTACTNA'EJudith George CIC,CPIA,CPIW FIAI/Cross Insurance PHONE (603)669-3218 FAX '(603)645-4331 1100 Elm Street E-MAIL,,.jgeorge@crossagency.com INSURERS AFFORDING COVERAGE NAIC tl Manchester NH 03101 INSURER A:Continental Western Ins Co INSURED Fences Unlimited, Inc. INSURER B:Union Insurance Company Mis-Bec of NH, Inc. dba The Stove Shoppe INSURERCAcadia Ins Co. The Commons INSURER D:Granite State WC Manufacturer's 25 Indian Rock Road, Route 111 INSURER E: Windham NH 03087 INSURER F: COVERAGES CERTIFICATE NUMBER:14-15 All lines- NH WC REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUB POLICY EFF POLICY EXP LTR POLICY NUMBER M /D / MM / LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED SES COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ 250,000 A CLAIMS-MADE ❑X OCCUR CPA0311123 1/1/2014 1/1/2015 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICYFX PRO- Fl X LOC $ AUTOMOBILE LIABILITY EO aBINEDISINGLE LIMIT 1,000,000 B ANY AUTO BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED CAA0311124 /1/2014 1/1/2015 BODILY INJURY Peraccident $ AUTOS AUTOS ( ) X NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Peraccident $ Auto Expansion Endorsement $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 C EXCESS LIAR CLAIMS-MADE AGGREGATE $ 5,000,000 DED I X I RETENTION$ 5,OOC CUA0311125 /1/2014 1/1/2015 $ D WORKERS COMPENSATION WC0120140000327WC S_TA TU- OTH- AND EMPLOYERS'LIABILITY Y/N X u ANY PROPRIETOR/PARTNER/EXECUTIVE (3a.) NH OFFICER/MEMBER EXCLUDED? N/A E.L.EACH ACCIDENT $ 1,000,000 (Mandatory In NH) All officers included /1/2014 1/1/2015 E.L.DISEASE-EA EMPLOYEE $ 1,000.000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Refer to policy for exclusionary endorsements and special provisions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN For Informational Purposes Only ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE J George CIC,CPIA,CPI ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS0251201005I.o1 Tha Arnpn nama anrd Innn ara ranis4Arpr1 markt of ArORn De Commonwearth of tbfassae/aasefts Department q ffndifs1firclAcczelents • - Offlee ee gffftvestigations 6II0 Washington Street -Boston.,HA 02111 wmmass gov/clza Wgrkexcs'Compewation bsuxance Affidavit:Baderes/Codtractoro/ElectriclapsfPl*u era App Rant Mormation Please Print e itbXy I' Q,� �r Name(BusinessloxganizationlPvdz`vidual}:�" �� �/�•. ���'! � jr7- A.ddress• ��0 ) CxtylS�afe/ftp:• L) Phone�: 3i /V.�/�• , . Are rixim employer?Ckeektheappropriatebox: Type of project(required): 4. El lam a general.contractor and T 1 I ana.a employer with 5 6. New constxtiction employees(full aud(ox ar-time)T have lifted the sub-contractors 2,[] T am.a sola proprietor or partner listed on the attached sheet. 7• Remodeling slip and`haveno.employees These sub-contraetoxshave S. []Demolition worlting forme in any capacity, workers'comp.insurance, 9. ❑Building addition [Nb workers'comp.insurance 5. ❑We area coxporaj on and its 101]Electrical repairs or additions required.] officers have exercised.their 3.El Z am a homeowner doing all right of exemption p or MGL 11.[[Plumbingrepairs or additions myself UToworkers'comp. c.152,§1(4),andwehaveno 12.[]Roofxepairs Mom insurancexe ed. employees.[No workers' ,,,},, ( �� comp.insurance required.] 1� ©tliex_��( i,�l� =Any EL at checks box#1 must also fll outthe section below shovwingtheir workers'comp ems atton.polzcy information. Homeowners who sAmitthis affidavit indicating they go doing att work and then hire outside contractors must submit a now affidavit indieat3ug such, TContractors that choDktbis bob const attached as gdditional sheet showingthe nams ofthe sub:contractors andtheir workers'camp.policy informafion. Yam an emyloyer�that is,providing workers'eampetasation insurane,forYay employees; Beroty is�hepalley ancijo�i site in,fo�matior2. Txtsuxance Companylrlame:(�r1: �✓ Policy 9 or Selz ins.Lic. Expirat[on Date: j l Sob Site Address: G/+�. r4 Lh % jCity/State/dip: �(OLCP� /�' 01 Aftaeh a copy ofttteworkers'coinpensatfon•policydeclaration page(sb.owingIfte policy nulaher and expirationt crate). Failure to secure coverage as requireduuder Section 25A ofMGL o.152 can lead to the imposition,of criminal penalties of a flue up to$1,500.00 and/or one.-Yearimprisonment,as wallas cM1 penalties in the foam of STOP WORK ORDER and a fine o£up to$250.00 a day against the violator. B9.aaYfmi that a copy of this statement map be forwarded to the Office of Investigations of TA. r insurance age v cation. do Xtex eby e to u 2e airs an ties o ry&at trio informador��rov r eco aiio is true anct eosa�eet, - Si attire• Date: Phone#: G OfflciaZ use o nly, .Do not wfite in this area,to be comyleted by city or town official. City or Town: Perniit/Liceme 0 Issuing Authority(circle one): I.Board[of 13ealtIt 2.BuildingDepartment 3.0tyff- mm Clerk 4.Electrical Inspector 5.Plumbing Inspector f.Outer _ Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for Meir employees. Pursuant to this statute,an employee is defined as"..,ever,Y person hi the service ofanother under any conifract ofhire; express orhaplied,oral ox wxitten." AneT layer is defined as"an individual,partnership,association,corporation os other legal entity,or anytwo oxxmre t4a. ofthe oxego�ngengaged inajointenterprise,and in.cludingthelegalxepxesentativesofwdeceasedempio�ye�•,.oxthe redeivex or. tee of'an individual,partnership,association or other legal entity,employing employees. Iowe r t the owner of a dwelling house having notmore than three aparfmonts and who resides thexeina or Me o ccupaut ofMe dwelling house of another who employs persons to do maintenance,consfntctzon.ox repak work on such dwelling house or on the grounds oxbuilding appurtenant thereto shallnot'iiecause ofsuch employmentbe deemedto he an employes." MUL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to coust"ruct buildings in.the commonwealth fox any applicantwho has not pro duced•acceptable evidence of complfance withAe iusurance coveragerequirad:' Additionally,MGL chapter 152,§25C(7)states `Neither the commonwealth nor any of its political subdivisions shall entex into any contractfor the performance ofpublie workuntil acceptable evidence of compliance with the insurance requirements of this chapterhave beenpresentedta the contracting authority," .Applicants Please f11 out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),addxess(es)andphonenumber(s)along with their cextificate(s)of insurance. LfmitedLiability Companies(LLC)or M:m!tedUabilityPartnershnps(LLP)with no employees other that the members orpattners,arenotrequiredto canyworkers'compensation insurance, IfanLLCoxLLI'doeshave e�nployees,apolzcyzsxequired. Be advisedthatttlaisafidavitmaybesubmittedtotheDepartmentofludustdal Accidents fox c'onfrmation of insurance coverage. .Also be sure to sign and date the affidavit: The affidavit should be return ed to the city or town that the application for thepermit or license is being requested,not the DB�artment of Industrial Accidents. Shouldyou have any questions regarding the law or if you are xequixed to obtain,a*orkexs' comp onsatfon polfay.,please call the Department at the number listedholow. Selfrh=edcompanies shouldenter their self iusurance Incense number on the appropriate line. City or Town O.ffncials Pleasebesu e,thattlteafizdavitiscomplete andpxintec,legibly. Tb.eDepartmenthaspxovidedaspace attheboftom ofthe affidavit fox you to fall out in the event the Office of Investigations has to contact you regarding 6e-applicant. Please be-sure to fill into pemaft/license number whichwill be used as a reference number, Iu addition,art applicant that m-ust submit multiple perm-itpicensa applfcatiom in any given year,need only submit one affidavit indfcafnug current p ORGY information(if nocessary)and under"Yob Site Address"the applicant should write"all locations in (city or town):'A copy ofte affidavit thathas been officially stamped or marked by the city oxtown maybe provided to the applicantasp" of thatavalidaffidavit•rsonfile�oxf1toxepermitsoxlicenses, ,Anewafddavitmu stbeflledouteach year.Where ahome owner or citizen is obtaining a license oxpermit not related to auy business or commercial venture (i.e.a dog license orpermit to burn leaves eta.)said p erson is NOT required to complete this affidavit. The Office ofInvestigations would like to thank you in advance for your cooperation and should you have any questions, Please do not hesitate to give us a call. The Department's address,telephone anal faxnumber: The Gom-mQnwaath o 11 s achv.: Ptt, DTaximQut d.ada&al Accident [)fico offmsttgatCoAg 60 W@ Sue,a Boston,UA 02111 Tel 61M-2'&4.-00 W406 ax 1•-977M llevised 5 26-05 FRSE • w�w.zxta�,g�v�dia