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Building Permit #117-2011 - 855 WINTER STREET 8/9/2010
L OORTH BUILDING PERMIT 0. ,t Ztp ,,q TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: �7 Date Received A�R17ED,'Pa`,�5 ,,jam l� �SSACHU`-'�t i Date Issued: 7 IMPORTANT: Applicant must complete all items on this page :- _ �L.00ATJON� Y� _ fAv t 37 MA 4PROPE�RTY O;IN'IER ' F t7 7 : l 3 f MAP�21®'y �� P/NRCEi � ZONJNNG DISTRICTS Hi9,t C Disfnct y no r �� fi�'_`� _ - f� k Machine ShYop sVillage� -.des no'' TYPE OF IMPROVEMENT PROPOSED USE Reside Non- Residential New Building ne family . Addition wo or more family Industrial Aftemtion No. of units: Commercial epair, replacement Assessory Bldg Others: Demo i ion Other ` 'R�+'.";�"' f 7 t °. T � ti",� ,�"SF.,. •a-,'+A �� .- ",�„ -.-, Septic' UUell�fr 1 kFloodplalr� Wetlands r UUatershedstnct ~ j ; Arid Water_/S_ ewer = , IL DESCRIPTION OF WORK TO BE PREFORMED: Z, Gh J- Identification Please Type or Pri t Clearly) ' OWNER: Name: Phone: �l ?'- kw-a e?2,? Address: iICON RACTOyR' Name ;Phone �i t ..U. 1 s--'�..-.3 "'-`7 -. # q'. "'�`.""7-'!`§`" �.,r..�-.- ,r- +.. �-^^� ssww.^. ,..�• x-" y3� r• Adcfess= �;/O 'l� .. .wf , �S.upennsor's4S4 7.C®nstruction' Licertse 1 Moine Irnpro�e'mentLicerise > _,C- ,� Y �_'_ ' ,_,Expo_ bate ,�, tJr ; ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BOLDING�PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ .), (16 7 ,J 9 FEE: $ Check No.: �� �' Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to a guara ed S�gnatu�e ofaAgent/Owner wr , .' M. _v Signature of-con.racto ,_� _ Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer Swimming Pools Tanning/MassageBody Art Well Tobacco Sales Food Packaging/Sales Private(septic tank,etc. Permanent Dumpster on Site THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM J DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS I I CONSERVATION Reviewed on Siqnature COMMENTS HEALTH , Reviewed on Siqnature COMMENTS i Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted_ yes a Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street te kFIRE�DEPAR� M Temp Dumpster=on siyesr no ' Located at.124 Min Street _ S rs F�a epartment sig attire/da D R 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 I NOTES and DATA— (For department use) t I t 1 ❑ Notified for pickup - Date L Doc.Building Permit Revised 2010 i I I i 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 ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or.C.S.L. Licenses ❑ Co of Contract i PY ❑ Floor Plan Or Proposed Interior Work ❑ 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 ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/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 NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ' ❑ 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 ❑ Mass check Energy Compliance Report ❑ 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 Doc:Building Permit Revised 2008 1 Location No. 1/ —2 O// Date RAZI6 MORTN TOWN OF NORTH ANDOVER 1 .. A Certificate of Occupancy $ IT Building/Frame Permit Fee $ -3 sic Hus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 6.2 i 2 '3) A/ Building Inspector NORTH TO" of Andover No. 1 h LAKE O dower, Mass., COCMICMEWIC '- K � 5 4 %d ADRATED PP�,`� ! 7`SS BOARD OF HEALTH i Food/Kitchen Septic System 5 BUILDING INSPECTOR THISCERTIFIES THAT.....................................` ...... ........................ ...................•.................................•.:....................... Foundation 1, , � I has permission to erect..............:.... buildings on .. ..n.......^' � ��................................. Rough tobe occupied as....................... G.. ........V.. „l ..... .°-J�..................................................... Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final 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 ......................... `ILDIN'-m.,L:.......................... Service BUG INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR 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. SEE REVERSE SIDE Smoke Det. YANKE'E Fireplace & Grill City DATE 7 /22/10 140 South Main Street• Middleton, MA 01949-2489 (978) 774-1621 • Fax (978) 777-2683•(800) 445-2760 0 r- 6 G'- 2 -3 S 11- 0 - www.yankeefireplace.com E-mail: info@yankeefireplace.com SOLD TO: SHIP TO: BRIAN KEENAN 855 WINTER SIREEI j N . ANDOVER MA 01845 (617 ) 888-2225 ACCOUNT# DATE ORDERED DATE REQUIRED PAYMENT METHOD SALES PERSON 39615 7122110 JODI QTY. ITEM # DESCRIPTION UNIT PRICE EXTENSION 1 JOT350336 F3CB , MA11E BLACK WOOD 1 , 627 . 00 1 , 627 . 00 STOVE 1 ZFLKI"I"0625 6" X 251 Z-FLEX S/S LINER 725 . 00 725 . 00 K I I. 1 IMPB86 24 (.GAUGE 8" ICI 6" INC OR 24 . 00 24 . 00 DEC 1 IMPB824 24 GA BLK 8" X 2411 LEN . 00 . OBD 1 IMPB690 24 GA BLK 6" 90 12 . 00 12 . 00 1 IMPB624 24 GA BLK 6" X 24" LEN 13 . 001 13 . 00 1 IMPB612 24 GA BLK 611 X 12" LEN 8 . 00 8 . 00 1 INSTALLWOOD/DELLE II WOOD OR PELLET INSER-I 1 , 000 . 00 11 000 . 00 INS.IALLA110N INSIALLAIION OF WOOD OR PELLET INSERT. . * IF A LINER KI-1- IS NEEDED FOR IHIS INSTALLATION , FHE LINER KIF MUST BE PURCHASED SEPARATELY . * THE BALANCE OF THIS ORDER MUST BE PAID IN FULL PRIOR .IO INS-IALLAI_I N DALE BEI G SCHEDULED . * APPLIANCES WI1.H A BLOWER REQUIRE AN ELEC1-RICAL OU1 LE 1 SUPPLIED EY -!-HE CUSTOMER . * HOMEOWNER IS RESPONSIBLE lO HAVE _IHE i NET AMOUNT: TAX: A$20 fee will be charged for any check returned by our bank for any reason. INVOICE/ORDER Custom orders are non-refundable.All other orders are subject to TOTAL: a 20%restocking fee, Continued All quotes are valid for 30 days LESS DEPOSIT: Customer Signature Date NET DUE— I a YANKILEE e Fireplace & Grill (City DATE 7/ 140 South Main Street• Middleton, MA 01949-2489 (978) 774-1621 • Fax (978) 777-2683•(800) 445-2760 0 r- 6 1_r� AL 0 7 www.yankeefireplace.com E-mail: info@yankeefireplace.com SOLD TO: SHIP TO: BRIAN KEENAN 855 WIN_i ER S.I.REE1 N . ANDOVER MA 01845 ( 617 ) 888-2223 ACCOUNT# DATE ORDERED DATE REQUIRED PAYMENT METHOD SALES PERSON 30615 7 /22/10 JODI QTY. ITEM # DESCRIPTION UNIT PRICE EXTENSION CHIMNEY CLEANED PRIOR I'D IN _IALLAIION OF APPLIANCE. 1 PERMITFEE /WOOD LOCAL PERMIT FEES 48 . 00 48 . 00 EVERYTHING LOCATED IN S/I A EA S/N 36514 CHIMNEY SWEEP COMING NEX-F WEEK . ORDER IS PAID . OK _IO SCHEDULE I i NET AMOUNT: 3 , 457 . 710 � Possible Yankee installation TAX: 150 . 56 A$20 fee will be charged for any check returned by our bank for any reason. INVOICE/ORDER Custom orders are non-refundable.All other orders are subject to TOTAL: 3 , 607 . 56 a 20%restocking fee. All quotes are valid for 30 days LESS DEPOSIT: 3 , 6 0" .7 , 5 6 Customer Signature Date NET DUE— . 00 i i I I i � I i I i i i _, I �, 4 i i I I r t Jotul F 3 USA -r, W C Installation and Operating Instructions for the USA and Canada z LA D Exploded view 20 Y. k' JOTU L Kindly save these instructions for future reference. USA/Canada Installation and Operation Instructions for USA/Canada Installation et fonctionnement pour Canada Safety notice:If this solid fuel room heater is not properly installed,a house fire may result.For your safety,follow the installation directions.Contact local building or fire officials about restrictions and installation inspection requirements in your area.Save these instructions for future reference. Avis de securite: Une installation non appropriee de ce poele de chauffage risque de provoquer un incendie.Assurez votre securite en respectant les directives d'installation suivantes.Consultez les autorites locales du batiment ou de la prevention des incendies au sujet des restrictions et exigences relatives aux inspections d'installations dans votre region. Tested and listed by ITS,lntertek Testing Services, Middleton,Wisconsin. c(='� )us Tested to U.S.Standards:ANSI/UL 737 andANSI/UL 7482,Canadian Standards:CAN/ULC-S627-M93 Standards Check Building Codes The Jotul F 3 woodstove has been tested and listed to: When installing,operating and maintaining your Jotul U.S.Standards:ANSI/UL 737 and ANSI/UL 7482 F 3 woodstove,follow the guidelines presented in these Canada:CAN/ULC-S627-M93 instructions,and make them available to anyone using or servicing the stove. Tests performed by: Your city,town,county or province may require a building ITS,lntertek Testing Services,Middleton,WI permit to install a solid fuel burning appliance. Manufactured by: In the U.S.,the National Fire Protection Association's Code, Jotul AS.,P.O.Box 7411,Fredrikstad,Norway NFPA 277, Standards for Chimneys, Fireplaces, Vents and Solid Fuel Burning Appliances,or similar regulations,may Distributed by. apply to the installation of a solid fuel burning appliance Jotul North America Inc, 55 Hutcherson Drive, in your area. Gorham,Maine 04038,USA In Canada, the guideline is established by the CSA This heater meets the U.S. Environment Protection Standard,CAN/CSA-8365-M93,Installation CodeforSolid- Agency's Emissions limitsforwood heaters manufactured Fuel-Burning Appliances and Equipment. and sold after July 1,199o. Always consult your local building inspector or authority Under specific test conditions,this heater has shown having jurisdiction to determine what regulations apply heat output at rates ranging from 11,500 to 43 5oo BTU's in your area. per hour. The Jotul F 3 woodstove is only listed to burn wood. Do Accepted For Use not burn any other fuels. City of New York Department of Buildings Read this entire manual before you install and use your MEA 313-00-E new room heater. Jotul North America,Inc. Save these instructions and make them available to anyone using or servicing the stove. NATIONAL We suggest that our woodburning hearth FIREPLACE INSTITUTE' products be installed and serviced by professionals who are certified in the U.S. by the National Fireplace Institute®(NFI)as NFI Woodburning Specialists or who are certified in Canada by #TWo.dE.71TP�,,ing CERTIFIED Wood Energy TechnicalTrainin (WETT). g 3 USA/Canada Notices Reminder: • Be sure to read this entire manual before you install your local officials have final authority in determining if a or use your new 1otul F 3. proposed installation is acceptable.Any requirement,that is requested by the local authority having jurisdiction,that is • If this room heater is not properly installed,a house not specifically addressed in this manual,defaults to NFPA fire may result. To reduce the risk of fire,follow the 211,and local codes. installation instructions. Failure to follow these In the U.S. or in Canada, CAN/CSA-8365-M and local instructions may result in property damage, bodily codes. injury,or even death. • 10tul recommends that you have your new 10tul F installing the venting 3 installed by a professional installer of solid fuel burning appliances. TheJOtul F 3 can be vented from the top,the rear or from either the right or left side. Followthe instructions below • Extremely hot while in operation! Keep children, for the desired venting location. clothing and furniture away. Contact may cause skin burns. Top exit venting • Avoid creating a low pressure condition in the When top exit venting is desired,use a 3mm allen wrench room where the stove is operating. Be aware to remove the two set screws that secure the top casting that operation of an exhaust fan or clothes dryer to the sides of the stove and lift off the top casting. Lay can create a low pressure area and consequently thetopcastingon a flat surface upside down and remove promote flow reversal through the stove and the comm bolt from the traverse bar and remove the chimney system. The chimney and building, smoke outlet cover. however, always work together as a system - Reinstall the top casting,be sure to secure with the two provision of outside air, directly or indirectly to an atmospherically vented appliance will not set screws that were removed. See figure. guarantee proper chimney performance.Consult Fig,, your local Jotul authorized dealer regarding Upside down specific installation/performance issues. Top casting Stove pipe stop • Do not use chemicals or fluids to start the fire. Some fuels will, during combustion, separate carbon monoxide and generate it in the burn chamber.Carbon monoxide is toxic,so please follow the guidelines in this manual for proper operation of your Jotul F 3. • If you for some reason experience smoke"roll-out"from the stove,it may activate smoke detectors if installed in the house. 0 Traverse bar securing Stove pipe top Do not connect this stove to any air distribution duct or ca ne outlet cover to top g system. Rear exit venting 1.o Installation When rear exit venting is desired it will be necessary to "knock-out"the vent hole from the rear casting. If this solid fuel room heater is not properly installed a house fire may result. For your safety,follow the Remove the top casting of the stove by removing the two installation directions.Contact the local building or fire 3mm set screws that secures the top to the sides.The set officials about restrictions and installation inspection screws are located on the outside of the stove on the top requirements in your area. of each side panel. Using a lomm wrench remove the double rear heatshields from the back ofthe stove.Remove the front doorto avoid damage to the glass.Reminder:loss of the door washer will result in improperdoor alignment when reinstalling the door. 4 USA/Canada Using a claw hammer or a sma I[sledgehammer strike the Fig.3 center of the 6""knock-out"disc from the outside of the Direction into the stove. The"knock-out"disc will break into four wedges stove and may need to be tapped out.Touch up any remaining sharp edges with a file or hand grinder. Note:The ivoryJotul F 3's are rear vented from the factory. ° It is not necessary to"knock-out"the rear casting of the stove.However,if top exit is desired it is necessaryto install a smoke outlet cover on the rear outlet of the stove. The adaptor should be inserted into the stove until the Reinstall the top casting and front door, remembering bead on the adapter is flush with the top, back or side the washer.The two rear heatshields must be reinstalled casting. Now the adaptor is ready to accept single or on the stove. Remove the metal cover plates from the double walled stovepipe. See figure 4. heatshields and reinstall. Reminder:There is a small nut used as a spacer between the two heatshields.See fig 2. Fig.4 Fig.2 Adaptor bead should g be flush with stove Side exit venting Spacers ti 8 Each joint of chimney connector or stove pipe must be secured with at least three sheet metal screws to ensure that the sections do not separate. Stove pipe - chimney connector The chimney connector is a single walled pipe used to connect the stove to the chimney. For use with the Heatshield with listing 1otul F3 the chimney connector must be 6"in diameter, label should be installed with a minimum thickness of 24 gauge black steel. on the outside Aluminum and galvanized steel pipe is not acceptable for use with the Jotul F3.These materials cannot withstand the extreme temperatures of a wood fire and can give off If venting through the side is desired it will be necessary toxic fumes when heated. to remove the top casting. Using a 3mm alien wrench Each chimney connector or stove pipe section must be remove the two set screws that secure to the top to the installed to the stove flue collar and to each otherwith the side panels. Remove the front door to avoid damage to the glass. Reminder: Loss of the doorwasherwill result in male(crimped)end toward the stove. See figure S. improper door alignment when reinstalling the door. Using a claw hammerorasmall sledge hammerstrikethe Fig.5 center of the 6""knock-out"disc from the inside of the stove. The"knock-out"disc will break into four wedges and may need to be tapped out.Touch up any remaining sharp edges with a file or hand grinder. Reinstall the front i door,remembering the washer and the top casting. Crimped end installed toward the stove Installing the stove pipe adapter After the appropriate flue outlet in the stove has been established the stove pipe adapter(included with every stove)must be installed so that standard stove pipe can be installed onto the stove. Insert the end of the adapter with the four holes into the stove.These holes allowthe adaptorto be attached to the stove's internal collar,using the nuts and bolts provided with the stove. See figure 3. 5 • USA/Canada This prevents any amount of condensed or liquid creosote 2.0 Chimney requirements from running down the outside of the pipe or the stove top.All joints,including the flue collar connection must be secured with three sheet metal screws to ensure that the There are two types of chimneys suitable for the Jotul F3: sections do not separate. 1. A code-approved masonry chimney with a flue liner. z. A prefabricated chimney complying with the For the best performance the chimney connector should requirements for type HT (zioo°F) chimneys per UL be as short and direct as possible,with no more than two reqreq ULC 56zg. go° elbows. The maximum horizontal run is 36" and a recommended total length of stove pipe should not exceed The chimney size should not be less than the cross- io feet.Always slope horizontal runs upward 1/4"per foot sectional area of the flue collar,and not more than three toward the chimney. times greater than the cross-sectional area of the flue collar. No part of the chimney connector may pass through an attic or roof space,closet or other concealed space, or When selecting a chimney type and the location for the through a floor or ceiling. All sections of the chimney ce of the chimney,as well as the proximity of surrounding connectors must be accessible forcleaning.Where passage trees or buildings. through a wall or partition of combustible construction is desired,the installation must conform with NFPA zn or As a result,a short masonry chimney on the exterior of a CAN/CSA-6365,and is also addressed in this manual. housewill givethe poorest performance.This is because it can be very difficulttowarmthe chimney thereby creating Do not connect this unit to a chimney flue servicing inadequate draft.in extremely cold northern areas it may another appliance, be necessary to reline the chimney or extend its height to Do not use the connector pipe as a chimney. help establish draft. Oppositely,a tall masonry chimney inside the house is easier to keep warm and will perform the best. The following guidelines give the necessary chimney requirements based on the national code (ANSI-NFPA zn for the us.And CSA CAN-6365 for Canada). However, many local codes differfrom the national codetotake into account climate,altitude,or other factors.It is important that you check with your local building officials to find out what codes apply in your area before installing your new JotuI F3. Masonry chimneys When installing the Jotul F3 into masonrychimneyyou must conform to all of the following guidelines: • The chimneyflue size should not be less than the cross sectional area of the stove flue collar. • The cross-sectional area of the flue of a chimney with no walls exposed to the outside below the roofline shall not be more than three times the crosssectional area of the stove flue collar. • The cross-sectional area of the flue of a chimney with one or more walls exposed to the outside below the roofline shall not be more than two times the cross- sectional area of the stove flue collar. • Larger chimney flues should be relined with a listed or code approved liner. • The masonry chimney must have a fireclay liner or equivalent, with a minimum thickness of 5/8"and must be installed with refractory mortar.There must be at least 1/2"air space between the flue liner and chimney wall. • The fireclay flue liner must have a nominal size of 8" x 8",and should not be larger than 8"x 12". If a round fireclay liner is to be used it must have a minimum inside diameter of 6" and not larger than 8" in 6 USA/Canada diameter.If a chimney with larger dimensions is to be Chimneys shorter than 14 feet may not provide adequate used,it should be relined with an appropriate linerthat draft.This could result is smoke spilling intothe room from is code approved. the stove when loading the stove,orwhen the door is open. • The masonry wall of the chimney,if brick or modular In addition,inadequate draft can cause back puffing,which block,must be a minimum of 4"nominal thickness. A is a build up of gases inside the firebox. mountain or rubble stonewall must be at least 12"thick. • Anewly-built chimney must conform to local codes and Other times,chimney height can create excessive draft in their absence must recognize national regulations. which can cause high stove temperatures and short burn • When using an existing chimney,it must be inspected times. Excessive drafts can be corrected by installing a by a professional licensed chimney sweep,fire official, butterfly damper. Ifyou suspectyou have a draft problem, or code officer,to ensure that the chimney is in proper consult your dealer. working order. • No other appliance can be vented into the same flue. • An airtight clean-outdoorshould be located atthe base Wall pass-throughs of the chimney.Y Whenour installation unavoidably requires the chimney Y Y re q Y connectorto passthrough a combustible wall to reach the chimney,always consultyour local building officials,and be Prefabricated chimneys sure any materials to be used have been tested and listed If a prefabricated metal chimney is to be used it must be for wall pass-throughs. a chimney type that is tested and listed for use with solid fuel burning appliances. High temperature (ht)chimney In the U.S. standard UL103 forthe U.S.And high temperature standard The national fire protection association's publication, ULC S-629 for Canada. NFPA 211,standardfor chimneys,fireplaces,vents and solid fuel burning appliances permits four methods for passing The manufacturer's installation instructions must be through a combustible wall. Before proceeding with any followed precisely.Always maintain the proper clearance to method be sure to consult with your local building officials combustibles as established bythe pipe manufacturer.This to discuss any local code requirements. clearance is usually a minimum of 2",although it mayvary by manufacturer or for certain chimney components. Common method When passing through a combustible wall to a masonry Chimney height chimneythis method requiresthe removalof allcombustible Whether a masonry chimney or prefabricated metal materials from at least 12"around the chimney connectors chimney is used it must be the required height above the proposed Iocation.With a 6"round linerthe minimum area roof line. required would be 31"x 31"square. The requirement is: The space is then filled with at least 12"of brick around a The chimney must be at least 3 feet higherthan the highest fireclay liner. Remember,the liner must be ASTM C35 or point where it passes through the roof and at least 2 feet equivalent,with a minimum wall thickness of 5/8". higher than the highest part of the roof or structure that It is important to remember to locate the pass-through is within io feet of the chimney, measured horizontally. at least 18" from the ceiling for proper clearance to See figure 6. combustibles. It will be necessary to cut wall studs,install headers,and construct a sill frame to maintain the proper dimensions Fig.6 and to support the weight of the brick. The bricks must be solid brick with a minimum of 31/2" thick(4"nominal). At least 3 feet Refractory mortar must be used at the junction of the At least 3feet chimney and the pass-through liner. The pass-through liner must not penetrate the chimney liner beyond the inner surface of the chimney liner. Use extreme care when constructing the hole in the chimney liner,the tiles can shatter easily. See figure 7. io feet 7 USA/Canada Fig., 3.o Connecting to the Wood Stud 2" flue Liner Clearance to Chimney chimney Head 12" Masonry chimney 30.5 cm When installing a Jotul F 3 into a masonry chimney Passthrough construction: through a"thimble"(the opening through the chimney 12"Brick from wall to the flue),the thimble must be linedwith ceramic thimble to combustibles tile or metal and be securely cemented in place. Thimble:5/8" The chimney connector/stove pipe must slide completely Fireclay Liner or equivalent inside the thimble to the inner surface or the flue liner. It maybe necessary to make use of a thimble sleeve(a pipe Sill/Support with a slightly smaller diameter than standard stovepipe). i e. This special pipe can be easily installed into a thimble. See Figure 8. Fig.8 Connector ppipe must be flush wi{h the inside of the flue the In Canada Chimney Connector In Canada the standard has been established by the pipe Flue Tile canadian standard association.The installation must conform to CAN/CSA-8365,installation code for solid fuel burning appliances and equipment.Before proceeding be sure to consult your local building inspector. Thimble Common method This method requires the removal of all combustible Make sure the connector pipe or thimble sleeve does not materials from at least 18"(457mm)around the chimney protrude into the flue liner,thereby restricting the area connector's proposed location. With a 6"round liner the minimum area required would be 43"x 43"square. the smoke has to flowthrough.This bottle-neck will have a negative affect on the chimney system. It is important to rememberto locate the pass-through at The chimney connector should be sealed at the thimble least 25"from the ceilingto maintain the proper clearance with refractory cement and the stove pipe leading to the to combustibles. stove should have a minimum ofthree screws. The space that is cleared of combustible materials must Do not connect this stove to a chimney flue servicing then remain empty. Sheet metal panels can then be another appliance of any kind. used to cover the area. However,when using a panel on both sides of the wall each cover must be installed on noncombustible spacers at least 1"from the wall. If one Hearth-mount into a masonry fireplace panel of sheet metal is to be used it may be installed flush The Jotul F 3 may be installed into a masonry fireplace to the wall. provided the opening is a minimum of 281/2"high. The See section 5.3.E and 5.3.2 of CAN/CSA-6365-m9i. short leg package reduces the stove's height by 21/4". Consult your local building inspector, authorized Jotul When installing the Jotul F 3 into a masonry fireplace, Dealer, NFPA 211 in the U.S.or CAN/CSA-B635 in Canada code requires that the fireplace damper plate be removed for other approved wall pass-through methods. or securely fixed in the open position.A connector pipe must then extend from the stove's flue exit through the damper area of the fireplace and into the chimney tile liner.See figure 9. 8 USA/Canada Fig.g Fig.io Listed Cap— Fig.ii Storm Collar Listed himney Flashing Attic Tile liner Insulation Specified Shield clearance Connector extends to first flue the Combus Me to Cellg Ceiling.loi Stov pport Chimney Damper opening is sealed Connector with sheetmetal plate and a sealant Floor Protector 0 e The inside area of the flue liner must not be less than the area of the stove's flue exit,and cannot be more than three times greater than the cross sectional area of the stove's flue exit. If the chimney liner is too large to accommodate the stove,an approved relining system must be installed to resize the flue. A new sheet metal damper block-off plate must be installed around the connector pipe at the damper frame and sealed with the proper sealant (usually high-temp silicone). Fireplace installation must also observe the proper clearances to surrounding trim and mantels (addressed in clearance section of this manual).In addition,fireplace installations must also adhere to the floor protection guidelines specified in the following section. Prefabricated chimneys When installing the JOtul F 3 to a prefabricated metal chimney always followthe pipe manufacture's instructions and be sureto usethe components that are required.This usually includes some type of"smoke pipe adapter"that is secured to the bottom section of the metal chimney and allows the chimney pipe to be secured to it with three sheet metal screws.See figures to and». 9 USA/Canada s Clearances to walls and ceilings 4.0 Clearances to combustibles g The following clearances have been tested to UL and ULC Floor protection standards and are the minimum clearances specifically established for the Jotul F 3.(See next page) Floor protection under the Jotul F 3,must be one of the following: The following charts and diagrams give the required i. Any non combustible material with an insulative clearances you must maintain when installing the R value of m. Jotul F 3 near combustible surfaces. 2. Any UL,ULCorWH hearth board orprefrabricated non- A combustible surface is anything that can burn(i.e.Sheet combustible material. rock,wall paper,wood,fabrics etc.).These surfaces are not limited to those that are visible and also include materials The bottom heatshield(standard equipment)is required that are behind non-combustible materials. in all installations. Ifyou are not sure of the combustible nature of a material, Individual sections of floor protection must be mortared consult your local fire officials. together t,o prevent sparks from falling through to combustible materials. Any carpeting must be removed Remember: "Fire resistant" materials are considered from under the floor protection. combustible;they are difficult to ignite,but will burn.Also "fire-rated"sheet rock is also considered combustible. In the U.S.and Canada Contact your local building officials about restrictions and The Jotul F 3 must be installed on anon-combustible installation requirements in your area. surface extending a minimum of i6" for U.S. (46 cm for Canada) in front of the stove and 8"(20 cm) on the Using shields to reduce clearances remaining sides of the stove (measured from side and Pipe shields:When using listed pipe shields to reduce back panels). the connector clearance to combustibles,it must start i" above the lowest exposed point of the connect pipe and This will result in a minimum floor protection of 39 cm D x extend vertically a minimum of 25"above the top surface 39 cm W.for U.S.,and iO4 cm D x 99 cm W for Canada. of the stove. See figure iz. Double wall pipe:Listed double wall pipe is an acceptable In a rear vent installation the floor protection must also alternative to connector pipe heatshields. extend underthestove pipe aminimum of2"(5cm)beyond Wall-mounted protection: When reducing clearances either side of the pipe. through the use of wall mounted protection: In the U.S. Refer to NFPA 2ii, standard for chimneys, Fig.12 2„ fireplaces,vents and solid fuel burning appliances,for I ("— (5 cm) acceptable materials, proper sizing and construction guidelines. A In Canada, refer to CAN/CSA-6365, installation code for solid-fuel burning appliances and equipment, also for acceptable materials, proper sizing and construction A O A 39"U.S. guidelines. (104 cm Can) Stove mounted rear heatshield is standard equipment on all Jotul F 3's. No other stove mounted heat shield may be used. B 39" ►t (99 cm Can) Hearth Protection A:8"(20 cm) B:i6"for U.S.(46 cm for Canada) 10 USA/Canada Wall Shield for close clearance Combustible wall Wall shield =0 - Must be 30"wide and centred behind the stove. Must be i"off the wall and 1"off the floor. With standard legs,the shield must be 32"high. With optional short legs,the shield must be 3o"high. Combustible wall �---�Wall shield ewall shield must extend O a min.of 4"(102mm) past —C the side of the stove. IThewallshield must extend a min. of 4"(102mm) past the ash lip of the stove. Must be 1"off the wall and 1"off the floor. With standard legs,the shield must be 40"high. With optional short legs,the shield must be 38"high. Both shields must extend and join in the corner. Combustible wall Wall shield O The wall shield must extend a min.of 12"(305 mm) past the side of the stove. Thewallshield must extend a min.of 12"(305 mm)past the ash lip of the stove Must be 1"off the wall and 1"off the floor. With standard legs,the shield must be 40"high. With optional short legs,the shield must be 38"high. Both shields must extend and join in the corner. 11 • USA/Canada Jotul F 3 Clearances Stove Clearances Unprotected Surfaces Protected Surfaces Top vent/vertical per NFPA YI1 or CAN/CSA-13365-M Side Rear Corner Side Rear Corner Rear heatshield with 24" 25" i8" io" i4" io" Single wall pipe 61omm 635mm 46omm 255mm 355mm 255mm Rear heatshield with 18" i0" 14" 6" 6" 6" Double wall pipe or shields 46omm 255mm 355mm i50mm 150mm i50mm Stove Clearances Unprotected Surfaces Protected Surfaces Rear Vent/Horizontal per NFPA 2ii or CAN/CSA-13365-M Side Rear Corner Side Rear Corner Rear heatshield with 24" 25" 20" 10" 25" i8" Single wall pipe 6iomm 635mm 5i0mm 255mm 635mm 46omm Rear heatshield with 18" 14" i7" 6" 6" 6" Double wall pipe or shields 46omm 355mm 430mm i50mm i50mm i50mm Connector Unprotected Surface Protected Surface Clearances per NFPA 211 or CAN/CSA-6365-M Singlewall pipe-vertical installations i8"(46omm) 6"(i5omm) Double wall pipe-vertical installations pipe mfgr.listing pipe mfgr.listing Single wall pipe-horizontal installations i8"(46omm) 9" (230mm) Double wall pipe-horizontal installations pipe mfgr.listing pipe mfgr.listing Very important: Top vent/vertical-assumes the connector pipe is exiting off A the top of the stove and traveling vertically.if top vented O O to any horizontal runs —the stove's position is dictated by the connector pipe clearances. T D Q Rear vent/horizontal- assumes the connector pipe is existing out the rear of the stove and is traveling horizontally to the chimney. If rear vented to vertical run—the stove position is dictated by the connector pipe clearances. Dimensions in Inches represent U.S.requirements. A:Top to Mantel 34" 86o mm Dimensions in Millimeters represent Canadian B:Top to Top Trim 20 510 mm requirements. C:Side to Side trim i3" 330 mm D:Side to Side Wall 24" 6io mm Wall protection is discussed in further detail on page io of this manual. Maximum Mantel Depth: 11 i/2" 292 mm Maximum Top and Side Trim Depth: 11/2" 38 mm 12 L USA/Canada Notice Min protected rotected alcove: Accessories for woodstoves for clearance reduction have Assumes- been developed by many manufacturers.if not following Top exit,double wall pipe,and stoves rear heatshield. Minimum alcove width = 35"(8gomm) the methods of the installation codes,be sure that any Maximum alcove depth= 24"(89omm) accessory you choose has been tested by an independent Height above the top of the stove= 40"(9095mm) laboratoryand carries the laboratory's testing mark.Make sure to follow all of the manufacturer's instructions. In a protected alcove installation both side walls and rear Always contact your local building inspector or fire wall must be protected per NFPA 299 or CAN/CSA-B365.The officials about restriction and requirements in your area. wall protection must be elevated 9„from the floor and at Reminder,it is the local officials who have final authority least 9 off the combustible wall to allow for an air-flow. in the installations approval. Fig.94 Alcove TheJgtul F 3 is approved for installations in an unprotected 90”(255 mm) and protected alcove provided the following guidelines are followed: Stoves must be positioned as shown in figures 13 or 14. 6„ O 6" Max.depth (150) (150) z4,(610 mm) Alcove floor protection must be:A UL/ULC or WHI listed hearth board or a non combustible material with a minimum rvalue of1.1. Minimum unprotected alcove: _) Assumes- Min.35"(890 mm) Top exit,single wall pipe,and stove's rear heatshield. Minimum alcove width= 79"(9805mm) Rear exit alcove installations: Maximum alcove depth= 40"(9095mm) Unprotected alcove:Assumes singlewall pipe and stove's Height above the top of the stove= 68"(9730mm) rear heatshield. Top vent/vertical-assumes the connector pipe is exiting Minimum alcove width= 79 (9805 mm) off the top of the stove and traveling vertically. If top Maximum alcove depth = 40"(9095mm) vented to any horizontal runs —the stove's position is Alcove ceiling above top of stove= 68"(9730mm) dictated by the connector pipe clearances. Protected alcove:Assumes double wall pipe and stove's rear heatshield. Fig.13 Minimum alcove width= 35"(89omm) Maximum alcove depth= 30"(76omm) Alcove ceiling above top of stove= 40"0015mm) 25"(635 mm) [(61 O 24" Max.depth mm) (61omml) 402(9095 mm Imo---- --�-I 79"(9805 mm) i 13 i -� -- --.- i • USA/Canada Never overfire the stove Adding fuel When reloading the stove while it is still hot and a bed of If any part of the stove or chimney glows,you are hot embers still exist,follow this reloading procedure: overfiring,and a housefire orserious damagetothe stove Always wear gloves when tending to the stove. or chimney could result. Immediately close down the air push the air control lever to the full open position(far control if you notice this condition. right). • Wait a few seconds before opening the door. Starting and maintaining a fire • Use a stove tool or poker to distribute the hot embers Burn only solid wood directly on the bottom grate of theequally around the firebox. • Load the fuel,usually with smaller logs first. stove,do not elevate the fire in any way. . Close the door,be sure to latch the door tightly. • Wait 5—10 minutes before adjusting the primary air The ash pan door on the stove must always be securely to the desired heat output setting. closed when the stove is in operation. (If you have at least a z" thick ember bed when Burning the stove with the ashpan open will over-fire the reloading, it may be possible to close the door and immediately adjust the air control setting). stove and cause interior damage. With the primary air control lever and the start-up air Creosote and Soot Formation and the Need control lever in the full open position(far right),start with for Removal several sheets of crumbled newspaper placed directly on When wood is burned slowly,it produces tar and other the grate. On top of the newspaper,place several pieces of small dry kindling(approx.i"in diameter)with two to organic vapors which combine with expelled moisture three larger logs(approx.3"to 5"in diameter)on top. to form creosote.These creosote vapors condense in the relatively cool chimney flue of a slow burning fire.The Lightthefire and close the door,slowly buildingthefire by creosotethat accumulates intheflue is highlyflammable adding largerand larger logs.Close the start-up aircontrol and is the fuel of chimney fires. To prevent a chimney lever after the fire isestablished and newfuel lightseasily. fire,the creosote needs to be removed by sweeping the Be sure to follow the break-in procedure before creating chimney and flue connector.The frequency of sweeping a fire that will damage the stove. will depend on how you operate your stove, but it is important to inspect the flue after every two weeks of Once the stove has reached a surface temperature range use.An accumulation of 1 4"or more on the sides of the of between 40o°and 6o0°,adjust the primary air control flue or connector is considered hazardous and should be lever as necessary to generate the heat output and burn removed. time desired. In the event that creosote in you rchimneyorflueconnector Jotul recommends the use of a magnetic stove top ignites,the resulting fire is often accompanied by a roaring thermometer to monitor the surface temperature of the noise and a crackling sound as flakes of burned creosote stove. The optimum surface temperature range for the break loose.If you suspect you are having a chimney fire, most efficient burn is between 40o°and 6oc° immediately close the draft regulator and make sure the stove door is closed. Call the fire department and get See figure 16 below for the optimum locations of a stove- everyone safely out of the house. top thermometer. Trying to extinguish the fire in the stove will not help.In fact it can make the matter worse by allowing oxygen through the door,which then supports the fire in the chimney.When the roaring and crackling has stopped,you should resist the temptation to open the door and look at Fig.t6 the fire.The fire may have suffocated,but could rekindle when you open the door.After a chimney fire,do not use your stove until the chimney and the flue connector has been cleaned and inspected to ensure that no damage O O has been sustained. Stove top thermometer 15 USA/Canada 6.o Maintenance 2. Carefully remove all of the glass clips from the inside of the door. Ash removal:Of course,for your protection always wear 3• Gently remove all pieces of the glass panel and safety gloves when handling the ash pan. gasketing. 4. Remove all remaining debris from the glass area using Ash removal will be required periodically depending a wire brush. on how frequently the stove is used.Conveniently,the 5• Applya small bead of gasket/stove cement andthe new Jotul F 3 isequipped with an ash pan assembly for easy ash gasket.Do not overlap the ends of the gasket rope. removal,without the need for opening the front doors. 6. Center the new glass panel over the gasket and reinstall the glass clips.See figure 17. The ash pan door is located under the front ashlip of Important: The side of the glass treated with an the stove.To open the ash door rotate the door knob infrared coating (marked on the perimeter) should counterclockwise to unlatch the door and clockwise to always be facing outward. It is extremely important to latch the door. tighten the glass clips slowly and in a repeating pattern, like tightening the lugs on an automobile wheel. Remove the ash pan. When the stove is in operation 7• It may be necessary to retighten the glass clips after always close the ash pan door before leaving to dispose the stove has be burned and the gasketing has been of the ashes. seated. The ashes should be placed in a metal container equipped with a tight sealing lid.The container should be placed on Chimney System a noncombustible flooror on the ground,well awayfrom The Jotul F 3 is designed to burn cleanly and efficiently all combustible materials, pending final disposal. If the when used according to the guidelines in this manual. In ashes are disposed of by burial in soil or otherwise locally orderto maintain proper performance,you should inspect dispersed,theyshould be retained in the closed container the chimney and chimney connector at the beginning of until all cinders have thoroughly cooled. each heating season and then,twice a month during the heating season.Clean the chimney whenever creosote Glass care and fly ash accumulation exceeds i/4 inch in any part of Cleaning: On occasion it will be necessary to clean the the system. carbon deposits and fly ash off of the glass.If the carbon Chimney brushes are available from your local Jotul dealer and fly ash are allowed to remain on the glass for an or hardware supply store.Your dealer can also refer you to extended period of time it could eventually cause the a reputable,professional chimney sweep who will have all glass to become etched and cloudy. Any creosote,which the equipmentto ensure a complete and properjob.Failure might deposit on the glass,will burn off during the next to keep the chimney system free of creosote and build up hot fire. could result in a serious chimney fire. The proper cleaning procedure is as follows: 1. Glass needs to be completely cool. 2. Only use a cleaner that is specifically designed for this purpose.The use of abrasives will damage the glass and ultimately leave the glass frosted. 3. Rinse and dry glass completely, before burning your stove. Important: Replace glass only with a ceramic glass panel specifically designed for the Jotul F 3. Do not use substitutes. Replacement glass panels can be ordered through your Jotul dealer. Glass removal: Always operate the doors slowly and cautiously to avoid cracking or breaking the glass.Never use the door to push wood into the firebox.If the glass becomes cracked or broken follow this procedure for replacement: Never operate the stove with a cracked or broken glass panel. 1. Remove the door from the stove and place on a flat surface. 16 _ � - 1P. L�J0411/iY1072!llP�� M .fX,JtiQ'.(,/y�6QP�6 _ n J of Building Regulatio//ns and StanJnrJs F= 10ME IMPROVEMENT CONTRACTOR l.ic ter; ' 1 bcfor- Registration: 161023 Boar Expiration: 9/17/2010Tri 274958 One Type: Individual Bost(? JAIMES P. E JR. JAMES V4' F- 9 BEAR HUDSOPi. 1 4 2 a :.,4 A ()cpar-tmcnt (it' Public �%afct% Board 1rf Ruilding Rc�ul;rti�+n. .(n(1 �t.urr�tr't!� Con truelioi'9 Su ery > r •l - {� o Sc�ecia.td License License: CS SL 101040 iRestricted to. RF,WS,SF,DM . ry JAMES WHITE 9 BEAR PATH LANE HUDSON, NH 03051 zv, �-� - -t•�-` Fxp+ration: 7/3/2012 ( ,.,m, ,",.❑ Tr-: 101040 A The Commonwealth of Massachusetts Department of Industrial Accidents Qffce of Investigations 4-' � � 600 Washington Street r w , Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information r� f �Pleas(ee P'rint Legibly / / Name(Business/Organization/Individual): j\�1; F �o L L/6)� J�/r L t ! L I Ma- �2r L L Address: lVO AOc.)%H PMW l City/State/Zip: /// I.lD D ZF7 U PJ14A 0 t'/g7Phone#: A,ree,you an employer? Check the appropriate box: Type of project(required): 1.LD'1 am a employer with 4. [J I am a general contractor and I have hired the sub-contractors 6. ❑ New construction employees(frill and/or part-time). 2.El I am a sole proprietor or partner- listed on the attached sheet. 7. F-1 Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity. employees and have workers' 9. E]Building addition [No workers' comp.insurance comp.insurance. required5. ❑ We are a corporation and its ME] Electrical repairs or additions officers have exercised their 11. Plumbin re airs or additions 3.❑ 1 am a homeowner doing all work g p myself. [No workers'comp. right of exemption per MGL 12.E3Roof repairs insurance required.] t c. 152; §1(4),and we have no employees. (No workers' 13.0 Other 6- L/� �S. � S comp.insurance required.] o,LIla- Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. +Homeowners who submit this affidavit indicating they are doing all work and then hire outside 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 trust provide their workers'contp.policy number. I am an emphgyer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. �+ Insurance Company Name:_/V A �/U I`) r�,�P1AJ 0' 6- /�i Q C1/) Policv#or Self-ins.Lic.#: y3 Expiration Date:G Job Site Address: City/State/Zip: 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 a inst the violator. Be advised that a copy of this statement may be fonvarded to the Office of Investigations of the A f insurance coverage verification. I do hereby certify nder a pains d pen/ res of jury that the in formation provided above is true and correct. Signature: Phone#: 9 7 0 - :_�- — f 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 He j1th 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: ACORQ CERTIFICATE OF LIABILITY INSURANCE DATE{MMIDD/YYYY) of/04/2010 PRODUCER 781.438.5000 FAX 781.438.5028 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION New England Heritage Insurance Agency Group, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 335 Main Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Stoneham, MA 02180 INSURERS AFFORDING COVERAGE NAIC# INSURED N E F P INC DBA INSURERA: National Grange Mutual 14788 DBA: Yankee Fireplace & Grill City INSURER B: 140 SOUTH MAIN ST INSURER C: MIDDLETON, MA 01949 INSURER D: INSURER E: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMBS LTR NSR DATE MWDD/YYYY DATE MWDDIYYYY GENERAL LIABILITY BP81906S 12/31/2009 12/31/2010 EACH OCCURRENCE $ 1,000,000 GE To RE COMMERCIAL GENERAL LIABILITY PREDAMM SES Ea occurrence $ 50,000 CLAIMS MADE Fx_1 OCCUR MED EXP(Any one person) $ 5,000 A X PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY JECT PRO- LOC AUTOMOBILE LIABILITY M1B1906S 12/31/2009 12/31/2010 COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ 1,000,000 ALL OWNED AUTOS BODILY INJURY A X SCHEDULED AUTOS (Per person) X HIRED AUTOS BODILY INJURY X NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S ANY AUTO OTHERTHAN EA ACC $ AUTO ONLY: AGG S EXCESS I UMBRELLA LIABILITY CUB1906S 12/31/2009 12/31/2010 EACH OCCURRENCE $ 1,000,000 OCCUR FICLAIMS MADE AGGREGATE S 1,000,000 A $ RDEDUCTIBLE $ X RETENTION $ 10,000 $ WORKERS COMPENSATION W1096943 01/05/2010 01/05/2011 X I TORYWCER AND EMPLOYERS'LIABILITY - LIMIT ANY PROPRIETORIPARTNERIEXECUTIVE[:] E.L.EACH ACCIDENT $ 500,000 A OFFICERWEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-FA EMPLOYEE $ 500,000 It yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT I$ 500,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT]SPECIAL PROVISIONS For Insurance Purposes Only. Specimen Copy. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ��' Sp cimen Copy Ildilliam Kelly/IDA ACORD 25(2009/01) ©1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD