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HomeMy WebLinkAboutBuilding Permit #1044-15 - 328 MAIN STREET 6/11/2015 Ft MOa oT b q� BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION 141 - Permit NO: t ` Date Received ° ` • - 'a T 09q toc.ucq�y1• Date Issued: CHU IMPORTANT:Applicant must complete all items on this page LOCATION 328 Main St Print PROPERTY OWNER Eugene Beliveau&Maryann Beliveau Print MAP NO+ 55- PARCEL:1td- ZONING DISTRICT: R4 Historic District yes no D DlS�� Machine Shop Village ye no ?j TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building bd One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial x Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑Well ❑ Floodplain ❑ Wetlands ❑ Watershed District ❑ Water/Sewer Install stainless steel flue. Connect wood stove. Identification Please Type or Print Clearly) OWNER: Name: Eugene&Maryann Beliveau Phone: 978-828-4393 Address: 328 Main St North Andover, Ma CONTRACTOR Name: Restoration Management, LLC Phone: 603-264-1127 Address: 100 Cad Dr, Unit 11 B Manchester, NH Supervisor's Construction License: Exp. Date: cs-106038 9/26/2015 Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Team Engineering Phone: 603-497-3137 Address: 676 North Mast St, Goffstown, NH Reg. No. 4 FEE SCHEDULE:BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ 2.5oo I oo FEE: $ so Check No.: Receipt No. NOTE: Persons contracting with u registered contractors do not have access to th gu my fund Signature of Agent/Owner Signature of contractor :< t%ORTH BUILDING PERMIT oF�t�Eo TOWN OF NORTH ANDOVER 0 APPLICATION FOR PLAN EXAMINATION Permit No#: Date Received �RA7ED o* 5 � Date Issued: SSgcHus�� 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 0 Septic Ell-Well ❑'Floodplain ❑Wetlands E] Watershed District 0 Water/Sewer _ DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please Type or Print Clearly OWNER: Name: Phone: Address: Contractor Name: Phone: Email: Address: 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 contracting with unregistered contractors do not have access to the guaranty fund Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming P0018 ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Pennanent Dumpster on Site ❑ 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 Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes I Planning Board Decision: Comments Conservation Decision: Comments y Water& Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: + Located 384 Osgood Street FIRE DERAReTME ., - w Nom- Temp ®inter o s e�yes``� � ' ,'a, Lo ated at lj�24 Main Street Fire DepZrftment s g`afNO 1 ® L i ension 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 DANCER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA-- (For department use) I I i ❑ Notified for pickup Call Email Date Time Contact Name Doc.Building Permit Revised 2014 Building Department 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 4� Building Permit Application 4, Workers Comp Affidavit 4 Photo Copy Of H.I.C. And/Or C.S.L. Licenses Copy of Contract 4, Floor Plan Or Proposed Interior Work Engineering Affidavits for Engineered products OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks Building Permit Application Certified Surveyed Plot Plan Workers Comp Affidavit Photo Copy of H.I.C. And C.S.L. Licenses Copy Of Contract Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) Mass check Energy Compliance Report (If Applicable) Engineering Affidavits for Engineered products OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) Building Permit Application 4 Certified Proposed Plot Plan Photo of H.I.C. And C.S.L. Licenses Workers Comp Affidavit Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) Copy of Contract 2012 IECC Energy code 4� Engineering Affidavits for Engineered products OTE: 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 Doe:Building Permit Revised 2014 2cl Location / No. Date . - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee S-30-%Plw � Foundation Permit Fee $ Other Permit Fee $ �, TOTAL $ Check17 # " Building Inspector l�s� '1�,��s V �3 3 �S 4�� 1� � s��, ��� �� . HomeWAbout Us NewsNewsl (Links Toolsl JHelp Deskl IProductsQContact UsF (Log InQQ IIIII+++`rr111 vvv`"aaa III+NNN Illrrrt��iii Site Search:C English Chimney Venting Fireplaces `2 MC4M Direct Temp I Gas Available In: 1,Fun Product Literature Direct Temp 1 Pellet DOUBLE WALL STOVE PIPE (DSP) • Direct-Temp/Multi-Fuel View Documents Double Wall Stove Pipe DSP-DOUBLE WALL STOVE PIPE (DSP) • DCC-Double Wall Stove Black Stove Pipe connects a Wood Installation Pipe Stove to Insulated Chimneys. View Documents Selkirk RV Type'B'Vent Double Wail system features a Selkirk QC Type'B'Vent Black Aluminized Steel outer casing and Stainless Steel inner liner.6" • Energy Vent B-Vent(3"-7") clearance to combustible materials. Resources Energy Vent B-Vent(8"-36") 6",7"&8"inner diameters. • Flexi-Liner Aluminum Flex View Documents I Liner • Model DFS Dual Fuel(Small) Piping System ONLINE TOOLS • PL Pellet Pipe Saf-T Liner(USA Only) �Qr - Saf-T Pipe(USA Only) "EUGIR • Saf-T Vent OULIVE PLAEDHMS,. Versa-Liner VP Pellet Pipe /; SELKIRK. IIISTALLATIO93 GUIDES '« J1, KIRK. r DEALER LOCATOr i SELKIRK U f»`i 71.' ONLINETRAINING Selkirk Home Copyright©2008 Selkirk Corporation.All Rights Reserved. Web Site design&maintenance: Imaqination Plus Inc. Privacy Policy Contact Us I i i 16in. Adjustable 3.5in, 3.5in, — 7,5in, 3.5in, 1.75in_ -w— 5.51n. C � O N nj -iAr N m Q O t m DSP INSULATED WALL THIMBLE SIZE A B C D IN MM IN MM IN MM IN MM 6in, 6.0 152 10,0 254 16.5 419 14.0 336 71n. 7,0 178 11,0 279 17,5 445 15.0 381 8in_ 8.0 203 12.0 305 18,5 470 16.0 406 tsjr/0106/dspiwt 0 1 a [DO [PINSTALLATION INSTRUCTIONS FACTORY BUILT CHIMNEY CONNECTOR A MAJOR CAUSE OF CHIMNEY CONNECTOR RELATED FIRES IS FAILURE TO MAINTAIN REQUIRED CLEARANCES (AIR SPACES) TO COMBUSTIBLE MATERIALS. IT IS OF THE UTMOST IMPORTANCE THAT THIS DOUBLE WALL CHIMNEY CONNECTOR BE INSTALLED ONLY IN ACCORDANCE WITH THESE INSTRUCTIONS MAEff c mwsm us LISTED Tested to *UL103HT & ULC-S641 PLEASE READ ALL INSTRUCTIONS BEFORE BEGINNING YOUR INSTALLATION. FAILURE TO INSTALL THIS SYSTEM IN ACCORDANCE WITH THESE INSTRUCTIONS WILL VOID THE CONDITIONS OF CERTIFICATION AND THE MANUFACTURERS WARRANTY . KEEP THESE INSTRUCTIONS IN A SAFE PLACE FOR FUTURE USE. SELKIRK CANADA CORPORATION SELKIRK LLC P.O.Box 526, Depot 1 14801 Quorum Drive Hamilton,Ontario L8L 7X6 Dallas,Texas,USA 75240 905-662-6600 972-560-2000 Fax905-263-9308 Fax972-560-2428 1-800-263-9308 1-800-992-VENT(8368) Toll Free Fax 1-866-835-9624 Toll Free Fax 1-877-393-4145 www.selkirkcanada.com www.selkirkinc.com 19/03/04 RM19896-1 TYPES OF APPLIANCES ATTENIZON± Your Chimney Connector is intended to connect a gas, liquid,or The orientation of all chimney connector components must solid fuel appliance normally producing flue gases of 650°C/ be with the crimped end (outer black pipe) pointing up, 1200°F (Canada), 540°C/1000°F (US - to the Temperature towards the chimney(see diagram below). requirements of UL103HT)or less to a factory built or masonry chimney. This Chimney Connector must not be enclosed or pass through attics, closets, floors, walls or ceilings, and must not be used in place of an insulated chimney section. Outer Black Pipe with The Minimum Clearance to combustibles (i.e.. walls, ceilings, crimped endInner Pipe with, etc.) is 6" 152mm . pointing up tcrimped end toward the pointing down himne Y For c mobile home installations follow the installation into the instructions for the mobile home appliance and use the appliance flue chimney connector clearance required by the appliance. outlet PRE-INSTALLATION GUIDELINES i Plan the installation of your appliance and chimney connector in ;j; ,`;�,I T-Tj17, such a way that your chimney connector run is as short and straight as possible. By having too long and/or multiple bend installations you can PARTS CHECK LIST reduce system draft which can affect the operation, and/or To complete a proper Double Wall Stove Pipe installation, the performance of your appliance and/or chimney system. following parts may be required: • Telescopic Length DSP*TL Ensure that you obtain any necessary building permits, and that • Adjustable Length DSP*AL-1 your installation will conform with all federal and municipal • Universal Chimney Adapt DSP*CA building code requirements. Before commencing installation: • 6" Pipe Length DSP*P6-1 • 12" Pipe Length DSP*P12-1 • 24" Pipe Length DSP*P24-1 CONTACT LOCAL BUILDING OR FIRE OFFICIALS - 36" Pipe Length DSP*P36-1 ABOUT RESTRICTIONS AND INSTALLATION • 450 Elbow DSP*E4-1 INSPECTION IN YOUR AREA. • 900 Elbow DSP*E9-1 • Tee Section DSP*TE-1 • Masonry Adapter DSP*MA Use this chimney connector only with an appliance listed by a • Damper Kit DSP*DK-1 recognized testing authority such as Intertek Testing Services • Finishing Band DSP-FB (Warnock Hersey), CSA, Underwriters Laboratories Inc., • Stove Adapter DSP*SA-1 or Underwriters Laboratories of Canada. - Oval to Round Adaptor DSP80TR • Flush Stove Adaptor DSP*FSA-1 The maximum recommended length of Double Wall Stove Pipe should not exceed 20ft. Reduce this maximum limit *Denotes size of product 6"(152mm), 7"(178mm), 8"(203mm) by 10%for every 900 bend or 5%for every 450 bend. INSTALLATION PROCEDURES Provide sufficient slope in the horizontal run of the chimney Install the appliance and chimney system according to the connector (20mm per meter, 1/4" per foot) to enable any installation instructions provided with them, ensuring that the condensed liquid or creosote to run back toward the appliance. required clearances are maintained Ensure that the horizontal chimney connector is securely SECURING OF THE DOUBLE WALL supported from the structure by means of metal or other non- STOVE PIPE (DSP) combustible supports at intervals not exceeding 1m (3ft). The following is to assist you in connecting the Double Wall All joints between sections of the chimney connector must be Stove Pipe (DSP) to the Chimney system. There are two (2) secured with three sheet metal (supplied) screws per joints. connecting methods. A Finishing Band (packaged with all Telescopic and Adjustable Lengths) or it may be purchased The black surface of the chimney connector may be touched up separately(DSP-FB). The second method is with the Universal with a high temperature flat black stove paint. Chimney Adaptor. Both methods can also be utilised on other chimney systems. If you are upgrading from a single wall stove pipe to the In all installations, all single wall parts of the chimney pipe Double Wall Stove Pipe Chimney Connector, have your adaptor must be fully covered by the Finishing Band or the chimney inspected by a certified wood technician or a certified Universal Chimney Adaptor. In order to accomplish this some chimney sweep. trimming may be required. I INSTALLATION OFTHE UNIVERSAL Step 2. Pre-drill 3 evenly spaced holes into the crimped end of the DSP through the Chimney Pipe Adaptor with a 3/32 metal CHIMNEY ADAPTER drill bit. Secure in place with 3#8 X 1/2" stainless steel sheet STEP 1 :Slide the Universal Chimney Adapter(CA)overthe male end metal screws (not supplied). of either the Stove Pipe Adapter(ASE)or the Smoke Pipe Adaptor all the way until snug to bead and beveled edge.See Figure 1. Beveled edge UNIVERSAL SUPERVENT'S C A4NEY + CHIMNEY PIPE' ADAPTER ADAPTER (CA) (ASE) UNIVERSAL Supervent/Superpro Selkirk Assembly C II!vr-1 Y SELKIRK'S Assembly ADAPTER CHIMNEY PIPE ADAPTER Figure 1B (CA) Finishing Band Installed FIGURE 1 Step 3. Wrap the Finishing Band over the crimped end of the STEP 2 : Pre-drill 3 evenly-spaced holes into the Universal Chimney DSP and the Chimney Pipe Adaptor. Ensure it is over the bead Adapter(CA)with a 3/32 metal drill bit.See Figure 2.These holes must and snug to the beveled edge or to the Basecap. Mark this also pierce the Stove Pipe Adapter(ASE)and the Smoke Pipe Adaptor. position using the 2 pre-punched holes in the Finishing Band as a template. Pre-drill with a 3/32 metal drill bit and secure the Finishing Band with the 2 supplied black sheet metal screws. Figure 1 B shows when it is all assembled. Pre-drill 3 holes evenly-spaced Step 4. On a Through-The-Wall Installation with a 90 degree SUPERVENTwith a metal bit. See Step 2. elbow, it may be necessary to cut the Chimney Pipe Adaptor U and/or the FinishingBand to the required width to be covered. q Ensure that the Finishing Band overlaps the crimped end of the DSP and overlaps the bead snug to the beveled edge or to V the Basecap as per Figure 2A & 2B. SELKIRKPre-drill 3 holes evenly-spaced Finishing with a metal bit. See Step 2. Band 1 90 Degree ElbgPipeAdaptor FIGURE 2 STEP 3 : Secure in place with 3 metal screws#6 X 1". NOTE: Tigthen screws until head meets metal casing.Do not over tightnen mney the screws such that the outer casing becomes deformed. INSTALLATION OF FINISHING BAND Telescopic-- (FB) Length Figure 2A Step 1.Position the Telescopic Length to the appropriate location over Supervent/Superpro Assembly the Chimney Pipe Adaptor. Ensure that it's final position will be cov- ered by the Finishing Band which is only 3'wide. The Finishing Band must overlap the crimped end of the DSP and the bead to the beveled Finishing edge of the Chimney Pipe Adaptor or to the Basecap(see Figure 1 A). Band 90 Degree Elbow Finishing Band to overlap the Bead and snug Chimney Position to the Beveled Pipe Adaptor Finishing Basecap edge of the Band snug to Chimney Pipe Band Finishing the Basecap Adaptor u Telescopic Length -- Position Position Finishing Finishing Figure 2B Band over 77 Band over Selkirk's Assembly the crimped Telescopic the crimped end Length end Supervent/Superpro Assembly Selkirk Assembly Figure 1A INSTALLATION TYPE#1 (See Figure A) sal Chimney Adaptor to the top of the Tee. Secure the sections This installation is used when the chimney system is located together with the 3 metal screws supplied ensuring that the elbow immediately above the appliance. is properly aligned for connection to the Telescopic Length. See 1. Place the Telescopic Le "Installation of Finishing Band" if used. Length on top of the appliance with the male (crimped)ped)end up,and the female end over the appliance outlet collar. 3. Install the Elbow/Tee/Chimney Adapter assembly to the top of Attach it with the 3 metal screws supplied. If the collar of your appliance the Telescopic Section and secure the sections together with the 3 is too large for the Telescopic Length to fit over you will have to use a stove adapter on top of the stove before installingthe Telescopic metal screws supplied. p Length. 2. If using an Universal Chimne Ad 4. Extend the Telescopic Length until the Chimney Adapter slides over y aptor place it on top of the Telescopic the chimney connector and secure the upper and lower sections of the Length and secure it in place with the 3 metal screws supplied. If using Telescopic Length in place with the 3 metal screws supplied. If the the Finishing Band see "Installation of Finishing Band installation requires more length than provided by the telescopic length 3. Extend the Telescopic Length until the Chimney Adapter slides over then install the foxed length(s) on the appliance and the telescopic the stove i adapter and secure the upper and ower sections of the length next to the 90 Elbow. All connections are to be fastened P PP together with the 3 metal screws provided with each length. Telescopic Length in place with the 3 metal screws supplied. If the installation requires more length than provided by the telescopic length Insulated Chimney Section then install the fixed length(s)on the appliance and the telescopic length next to the chimney. All connections are to be fastened together with the 3 metal screws provided with each length. Ceiling Support -y Insulated ChimneyLength o Chimney Pipe Adapter 9t Finishing Band or Universal Chimney Adapter 90°Elbow i Chimney Support 3 Metal Screws Tee Chimney Pipe Adapter Telescopic Length Section Finishing Band or Universal Chimney Adapter 3 Metal Screws 3 Metal Screws 3 Metal Screws „s" 3 Metal Screws Appliance Telescopic Length 3 Metal Screws FIGURE -B- Appliance INSTALLATION TYPE#3(See Figure C) This installation is used when a factory built chimney system is FIGURE -A- located through the wall behind 9 hmd theappliance. 1. Place the Telescopic Length on top of the appliance with the male (crimped) end up, and the female end over the appliance outlet collar . Attach it with the 3 metal screws supplied. If the INSTALLATION TYPE#2(See Figure B) collar of your appliance is too large for the Telescopic Length to This installation utilizing a Tee Section, is used when the chimney fit over you will have to use a stove adapter on top of the stove system is offset from the appliance,eitherto maintain proper clearances before installing the Telescopic Length. for the appliance or for incorporating a cleanout in the chimney system. 2. Install a 900 Elbow to the Chimney Adapter and then to the 1. Place the Telescopic Length on top of the appliance with the male chimney connector coming through the wall, ensuring that the (crimped)end up,and the female end over the appliance outlet collar elbow is properly aligned for connection to the Telescopic Length. and attach it with the 3 metal screws supplied. If the collar of your If the clearances of the appliance requires a greater horizontal appliance is too large for the T ° g Telescopic Length to fit over distance than that provided P 9t you will have p ded by the 90 Elbow, install the required to use a stove adapter pt on tip of the stove before installing the connector length to the elbow first,and then install your Chimney Telescopic Length. Adapter and secure the pieces together with the 3 metal screws provided. If using the Finishing Band see'Installation of Finishing 2.Install the 900 Elbow to the Tee Section branch and theUniver_ Band". 3. Extend the Telescopic Length until it connects with the 90° Elbow and secure the upper and lower sections of the Telescopic FIGURE -D- Length in place with the 3 metal screws supplied. Fasten the Telescopic Length and the 90° Elbow together with the 3 metal screws provided. If the installation requires more length than provided by the telescopic length then install the fixed length(s)on the appliance and the telescopic length next to the 900 Elbow. All Fixed Length connections are to be fastened together with the 3 metal screws 3 Metal Screws Chimney provided with each length. Liner 90°Elbow 3 Metal Masonry Screws Chimney 3 Metal Screws o Insulated Chimney Telescopic Length Masonry Sections Adapter Chimney Pipe Adapter 116' 3 Metal Screws Finishing Band or Universal Chimney Adapter Insulated Tee Section 90°Elbow 3 Metal Screws 3 Metal Screws Wall Thimble Appliance Telescopic Length 12" Insulated Section 3 Metal Screws Wall Support Bracket 3 Metal Screws RULE FOR SAFE OPERATION AND MAINTENANCE Appliance Do not use fuel materials corrosive to the chimney such as driftwood, chemically treated wood or garbage or over fire your solid fuel appliance. This can cause failure of the DSP Double Wall Stove Pipe and will void any warranties. FIGURE -C- 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 INSTALLATIONTYPE#4(See Figure D) of a slow-burning fire. As a result,creosote residue accumulates on the flue lining. When ignited,this creosote makes an extremely hot fire. This installation is the same as Installation Type #3 with the exception that the Chimney connecter is run to an existing With anew installation,the chimney should be inspected frequently Masonry Chimney instead of a Factory Built Chimney. (every 2 weeks if need be) to determine the rate of creosote formation. When familiar with the appliance and chimney 1. If your existing Masonry Chimney does not have a Chimney characteristics, the chimney should be inspected at least once Liner installed, it is required one be installed in order to make a every 2 months during the heating season to determine if a proper connection to the Double Wall Stove Pipe. creosote or soot build-up has occured. 2. Once your Chimney liner is in place, make sure the opening in If you see deposits more than 2mm (1/16") thick, clean all the Chimney or liner is the correct size to accept the Masonry connector pipe and chimney system mechanically(with a properly Adapter. Slide the Masonry Adapter into the opening in the sized plastic cleaning brush) to reduce the risk of chimney fire. chimney and into the branch of the Liner Tee until the collar of the Adapter fits flush to the wall of the chimney. If Masonry Adapter Contact a local professional chimney sweep for chimney cleaing is too long and the collar does not fit flush to the wall,or it projects services and advice. too far into the Tee the Adapter should be trimmed for proper fit. The Adapter should fit snug and not loose and there should be no Do not expect chemical chimney cleaners to keep your chimney gaps where heat or products of combustion might escape. If the clean. Their use does not negate the necessity of periodically adapter is loose fitting or gaps are present when it is installed they inspecting and cleaning your chimney. should be filled with a suitable filler. 3. After installing the Masonry Adapter follow the instructions in KEEP YOUR CHIMNEY AND Installation Type #3. CONNECTOR CLEAN! UUMLU (EMME&IM l� LIMITED LIFETIME WARRANTY: Selkirk Canada Corporation,("we","us","our")warrants Chimney&Venting products*to be free from defects in material and workmanship for as long as the original consumer owns the system.For products installed after January 1,2000,for a period of Ten(10)years from original installation,we will provide replacement product with a similar or like quality of available product,free of charge excluding any installation costs. From the Eleventh(11)through Fifteenth(15)years we will provide replacement product to the original consumer at a cost of 75%off the published Retail Price in effect on the date the claim is received excluding any installation costs. At expiration of the Fifteen(15)year term,we will provide replacement product to the original consumer at a cost of 50%off the published Retail Price in effect on the date the claim is received excluding any installation costs. LIMITATIONS: •- Products must be installed for their intended purpose. • - Products must be connected to an appliance listed with an accredited testing laboratory. WARNING: FAILURE TO INSTALL PRODUCTS ACCORDING TO THE MANUFACTURER'S INSTRUCTIONS WILL VOID ALL APPLICABLE WARRANTIES AND MAY RESULT IN FIRE, CARBON MONOXIDE POISONING OR DEATH. SEE OUR PRODUCT INSTALLATION INSTRUCTIONS FOR COMPLETE INSTRUCTIONS. WARRANTY COVERAGE: All lengths,tees and elbows,and components are applicable to warranty coverage. THIS LIMITED WARRANTY DOES NOT COVER: (a)any non-stainless base tee unit mounted or connected to an Insulated Chimney system; (b) costs (labor or otherwise **) associated with either removing a previously installed product,installing a replacement product,transportation or return of a product,or transportation of replacement product; (c)damage to the finish of products caused by the use of improper solvents/chemicals or improper cleaning methods; (d) damage resulting from failure to reasonably clean, care for or maintain products in accordance with our installation instructions/ recommendations; (e)damage(to products,appliances or structure)based on or resulting from improper installation or repair,misuse or abuse(including,but not limited to,excessive or improper operating condition),or alteration or adjustment other than in conformity with our installation instructions and specifications,whether performed by a contractor,service company,technician,or yourself; (f)any products that have been moved from their original installation site. (g)damage caused by burning driftwood,garbage,or any other prohibitive material has been burned in the appliance served by the chimney (h)damage that results from accidents such as fire,flood,high winds,"acts of God",or any other contingency beyond our control. ** Due to the wide variance in installation practices and other conditions beyond our control, we do not guarantee or in any way warrant the installation of Chimney and Venting products. CLAIM PROCEDURE: If you believe that a product is defective,notify us in writing at the following location: F K CANADA CORPORATION ,Depot 1,Hamilton,Ontario,CANADA,L8L7X6 RRANTY CLAIMS DEPARTMENT 2-5352 Notification should include a description of the product,model and serial number(if applicable)and a description of the product defect.Upon receipt of a written claim under this limited warranty and evidence of the date of purchase or installation,at our option and in our sole discretion, we will provide replacement product with similar or like quality of available product excluding any installation costs. We reserve the right to inspect or investigate any warranty claims prior to determining whether to provide replacement product. If,as determined by us that repair or replacement of the product is not commercially practicable or cannot be completed in a timely manner,we may refund the prorated purchase price paid for the product upon verification by providing a copy of your invoice or receipt of bill of sale. keep in safe place for future reference MODEL OF CHIMNEY: TYPE OF APPLIANCE: INSTALLATION DATE: DESCRIPTION OF INSTALLATION (Chimney and Chimney Connector configuration) I PURCHASED FROM: DEALER NAME: Address: City: Province/State: INSTALLED BY.- TECHNICIAN Y.TECHNICIAN NAME: Address: City: Province/State: --- "----------------------------------------------------------------------------------------------------- Please register your Chimney with the Manufacturer. Register Online: www.selkirkcanada.com Name: Address: City: Province/State: Postal/Zip: Model: Installation Date: Dealer Name: I i ' r \.`• . Y c.`�t s � A _ f - r F _ 4 \ 4'e e e r s`f �.5 . NORTH own of 2 E 1, SOAndover . , h ver, Mass, 1 coc"Ic"two-C S tJ - BOARD OF HEALTH Food/Kitchen PERM T T LD Septic System THIS CERTIFIES THAT .................. ........�r�.�. Com.. ..................................................................... BUILDING INSPECTOR has permission to erect buildings on szo........V+� `q,(„✓,�,,,,, ................ Foundation .......................... ..... .... ..... I .1 Rough to be occupied as .........�/�1Q..Q�.S. a�/;L;........��:.'C... ...... ........:................................... Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application Final 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 CONSTRUCTI Rough Service ................. .. .......... .. ......... ................ Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Buildinz 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. i The Commonwealth of Massachusettsfn Print Forrrr Department of Industrial Accidents -- Office of Investigations ' I Congress Street,Suite 100 Boston,MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leeibly N1n10(Business/Organization/Individual): Restoration Management,LLC Address: 100 Carl Dr, Unit 11 B. City/State/Zip: Manchester, NH 03104 Phone#:603-413-5883 Are you an employer?Check the appropriate box: Type of project(required): 1.21 I am a employer with 5 4. ✓0 I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. EJ New construction 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity. employees and have workers' [No workers' comp. insurance comp.insurance 9. ❑Building addition required.] 5. F1We are a corporation and its 10.E]Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself [No workers'comp. right of exemption per MGL 12.❑ Roof repairs insurance required.]t c. 152, §1(4),and we have no wood stove connec i employees. [No workers' 13.21 Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:Acadia Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: , A/V1� City/State/Zip: AunovLm 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 cern under the pains and enalties o e 'a that the info —,on provided above is true and correct. Si ature: ..._. - - - _ 'Date Phone#: Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#: i TOWN OF NORTH ANDOVER AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application MGL c. 142 A requires that the"reconstruction, alteration, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units...or to structures which are adjacent to such residence or building"be done by registered contractors, with certain exception, along with other requirements. Type of Work:Demolition and repair of existing structure Est. Cost 2,500.00 Address of Work 328 Main St,North Andover Ma Owner Name; Eugene and Maryann Beliveau Date of Permit Application: June 11,2015 1 hereby certify that: Copy of license attached. Registration is not required for the following reason(s): For office Use Only Work excluded by law Permit No. Job under$1,000 Date Building not owner-occupied Owner pulling own permit Other (specify) Notice Is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FIND UNER MGL c. 142A. Signed under penalties of perjury: I hereby apply for a permit as the agent of the owner: June 11,2015 Tom Kaloyanides,Restoration Management,LLC Date Contractor Name Registration No. OR: Notwithstanding the above notice, I hereby apply for a permit as the owner of the above property: Date Owner Name . ..........__........... ............ . dX/le - 0 Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massacusetts 02116 Home Improvement Coxltractor Registration `� o Registration: 180580 f � s' Type: Individual n �,; F µ 1 Expiration: 12/4/2016 Tr# 260880 y< t THOMAS KALOYANIDES � = THOMAS KALOYANIDES 21 100 CARL DR. UNIT 11 B ''y ��—x ' - MANCHESTER, NH 03103 �; ? Update Address and return card.Mark reason for change. x� o�s Address [:] Renewal [] Employment Lost Card SCA 1 C0 20M-05111 VLe�arrznza��zczsea.�Ll-a�C�i1�,al.�ac�uiaelld �R't Office of Consumer Affairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: n egistration 180580 Type: Office of Consumer Affairs and Business Regulation xpiration 121412 Individual 10 Park Plaza-Suite 5170 01 0 WE s:. Boston,MA 02116 THOMAS KALOYANIPES: , a THOMAS KALOYANIbt `! 100 CARL DR. UNIT 11B MANCHESTER, NH 03103 , Undersecretary i= - Not veli withott ignature Massachusetts _ Department of Public Safety Board of Building Regulations and Standards Construction Supen'isor License: CS-106038 �y 458 E HIGH Y�AI�IDES -1-1 Manchester*1 1 4 v y , commissioner E x pi ration 09/26/2015 A.AcadiaINSURANCE' WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 00 01 B0115 Issuing Company: Acadia Insurance Company 4 Bedford Farms Drive Suite 400 Bedford, NH 03110 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY RENEWAL INFORMATION PAGE NCCI Carrier Code No.: 33391 Policy No.: WCA 5081566- 12 Previous Policy No.: 5081566-11 1. Name Insured and Address Agency Name and Address 03492 Restoration Management LLC (603)673-7228 dba Legacy Flooring Boyd & Boufford Insurance Agency, LLC 100 Carl Drive 8 Main Street Manchester, NH 03103 Amherst, NH 03031 Other workplaces not shown above: Refer to Name and Location Schedule FEIN: 270880766 Risk ID No.: Bureau File No.: 280085502 Entity of Insured: Limited Liability Company POLICY PERIOD 2. The Policy Period is from 01/17/2015 to 01/17/2016 12:01 AM Standard Time at the insured's mailing address. COVERAGE 3. A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here: NH B. Employers Liability Insurance: Part Two of the policy applies to work in each state listed in item 3.A. The limits of our liability under Part two are: Bodily Injury by Accident$ 1,000,000 each accident Bodily Injury by Disease $ 1,000,000 policy limit Bodily Injury by Disease $ 1,000,000 each employee C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here: All states except ND, OH, WA, WY and states designated in item 3.A. of the information page. D. This policy includes these endorsements and schedules: See "Schedule Of Endorsements" WC 00 00 01 B 01 15 Includes copyrighted material of The National Council on Compensation Page 1 of 4 Insurance,with their permission. '► •d.arA WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY . SCHEDULE OF OPERATIONS New Hampshire Plan A Polis No.: WCA 5081566- 12 Name Insured and Address Agency Name and Address 03492 Restoration Management LLC (603)673-7228 dba Legacy Flooring Boyd& Boufford Insurance Agency, LLC 100 Carl Drive 8 Main Street Manchester, NH 03103 Amherst, NH 03031 Premium Basis Total Estimated Rate Per Estimated Code Annual $100 of Annual Loc ST No. Classification Remuneration Remuneration Premium 1 NH 5474 PAINTING OR PAPERHANGING 35,000 14.46 $ 5,061 NOC &SHOP OPERATIONS, DRIVERS 1 NH 5606 CONTRACTOR--PROJECT If any 2.91 $ 0 MANAGER, CONSTRUCTION EXECUTIVE, CONSTRUCTION MANAGER OR CONSTRUCTION SUPERINTENDENT 1 NH 8742 SALESPERSONS OR If any 0.62 $ 0 COLLECTORS-OUTSIDE 1 NH 8810 CLERICAL OFFICE EMPLOYEES 36,000 0.32 $ 115 NOC 1 NH 5645 CARPENTRY-DETACHED ONE 50,000 22.37 $ 11,185 OR TWO FAMILY DWELLINGS Subtotal: Premium Subject to Modification $ 16,361 9812 Increased Employers Liability Limits 1.10% $ 180 9898 Experience Mod, Eff 01/17/2015, Factor.860 $ -2,316 9887 Scheduled Credit.980 $ -285 Total State Standard Premium $ 13,940 -� 9740 Terrorism 121,000 0.016 $ 19 9741 Catastrophe(Other Than Certified Acts 0.016 $ 19 of Terrorism) WC 00 00 01 B 0115 Includes copyrighted material of The Nationalnal Council on Compensation Page Insurance, with their permission.