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TOWN OF NORTH ANDOVER
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PERMIT FOR GAS INSTALLATION
This certifies that .6fn��'
has permission for, gas installation . . P /q.'I � ....................
in the buildings of . ?)�.( lyb. L�� -. r . � ..........................
at P!� C-. L"-. YJ ............... er, Mass.
Fee. Lic. No. ....... ........
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7 3 16
M41SSACHLTSETTS UNIFORMAPPUCATONFORPERAWTO DO GAS FfrnNG
(Type or print) Date
NORTH ANDOVER, MASSACHUSETTS :Z- .12
Building Locations I 'D s-� Permit #
Amount
Owner's Name
New Renovation Replacement Plans Submitted
.0
(Print or type).
Check one: Certificate Installing Company
Corp.
Address A0, . :01'artner.
Business- Telephone C177 Firm/Co.
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Name of Licensed Plumber or Gas Fitter
�4,
INSURANCE ' COVERAGE Check one:
I have a current liability Insurance policy or it's substantial equivalent. Yes F-1 Noff
If you have checked yes, please indicate the type coverage by checking the appropriate box.
Liability insurance policy 0 Other type of in demnity Bond
Owner's Insurance Waiver: I am aware that the.licensce does not have the Insurance coverage required by Chapter 142 of'the
Mass. ���aws, an �that �gnature on this permit application waives this requirem
Check one:
Signature of Owner or Owner's Agent Owner Agent
I ICU y UIZI Lily LlldL 411 UL Ine (LeMlIS ano Mlormatlon J 11aVe SUt)Mjttc(j (or entered) in above application are true and accurate to the
best of my knowledge and that all plumbing work and installations perfon-ned under Permit Issued for this application will be in
compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws.
jCity/Town I
(OFFICEUSEONLY)
Signature of Licensed Plumber Or GIs Fitter
Plumber 4 �-- iLO -a
rj Gas Fitter License Number
ElMaster
M--lourneyman
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(Print or type).
Check one: Certificate Installing Company
Corp.
Address A0, . :01'artner.
Business- Telephone C177 Firm/Co.
rl
Name of Licensed Plumber or Gas Fitter
�4,
INSURANCE ' COVERAGE Check one:
I have a current liability Insurance policy or it's substantial equivalent. Yes F-1 Noff
If you have checked yes, please indicate the type coverage by checking the appropriate box.
Liability insurance policy 0 Other type of in demnity Bond
Owner's Insurance Waiver: I am aware that the.licensce does not have the Insurance coverage required by Chapter 142 of'the
Mass. ���aws, an �that �gnature on this permit application waives this requirem
Check one:
Signature of Owner or Owner's Agent Owner Agent
I ICU y UIZI Lily LlldL 411 UL Ine (LeMlIS ano Mlormatlon J 11aVe SUt)Mjttc(j (or entered) in above application are true and accurate to the
best of my knowledge and that all plumbing work and installations perfon-ned under Permit Issued for this application will be in
compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws.
jCity/Town I
(OFFICEUSEONLY)
Signature of Licensed Plumber Or GIs Fitter
Plumber 4 �-- iLO -a
rj Gas Fitter License Number
ElMaster
M--lourneyman
Location 30 6&tt/s�en
No. Date / 06f
TOWN OF NORTH ANDOVER
04
1
Certificate of occupanc y $
Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee tV0q7jfq
Sewer Connection Fee $
Water Connection Fee $
TOTAL $
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Building Inspector
12881 IIJ06/98 09:25 25. 00 PAID
Div. Public Works
Location
No.
Date I
40*Tpl
TOWN OF NORTH ANDOVER
of
so
Certificate of occupancy $
Building/Frame Permit Fee $
CH S
Foundation Permit Fee $
Other Permit Fee $
Sewer Connection Fee $
Water Connection Fee $
TOTAL $
Building Inspector
11/06/111 5 'biv. Public Works
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WOOD STOVE INSTALLAHON CHECKLIST Fi_;:,nrr vo:
Permit .30
A building permit is required for the installation of any solid fuel burning appliance. The building permit and
installation inspection are limited to the stove installation and -not to the stove construction.
Stove
A. N Used
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B. Typeiradiant Circulating
C. Manufacturer 'ab.No.
NameJ Model No. �Som rk" '3� Collar size
Dimensionsi Height —Length Width
Chimney
A.'New —Existing
B. Size (flue area)
C. Other appliances attached to flue (Number arid flue sjze� C>
0. -Prefab (Manufacturer—name and type)
E. Masonry/Uned Flue liner aype& manutaclut of)
Unlined
F Height (refer to diagrams) —cap
CHIMNEY HEIGHT
Hearth (non-comousnble),
A. Materials - Wr- I C,�
B. Sub -floor construction V sq
C. Minimum dimensions (ref er to ciagrarn)
Clear2nces and Wall Protection (.See stc-�e irZ,,a9at!cn I!e=rances chart)
A. Type of wall protection provided
B. Clearances (refer to diagrams)
FIREPLACE
CORNER
CFI!E I I
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WALLICENTER.
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REGULATIONS -
After obtaining the permit, there are three major areas in the stove installation process to
consider. First, the stove: second. the chimney; and third, the actual installation.
First: All new woodburning stoves installed in Massachusetts must be tested and
approved to U.L. 1482 -and/or U.L. 737 as appropriate. Used stoves may be approved by the
building department or the fire department. Every solid fuel -burning room heater shall bear a
permanent and legible factory -applied label containing at least the following information:
1. Manufacturers name and trademark
2. Model andlor identification number of the appliance
3. Type of fuel(s) approved �-Ooz�
4. Testing laboratorys name or trademark and location=v,
5. Date tested Zec-e-i'-�e-r �'\ \�C�"S.
6. Clearance to combustibles
a. Side
b. Rear
7. Teststandard
8. Labeiseriai number
Second: Existing chimneys should be. checked for the presence of a flue liner and
general structural condition. A smoke test may be used to determine if the draft is adequate, if
the flue is without obstruction and if there is any smoke leakage. A visual inspection of the
chimney is needed to check for creosote deposits, surface cracks or breaks, and if the damper
is in good working order. The following two areas related to the chimne . y qre important to
inspect. The area where the chimney penetrates through the floor of ceiling joists should be
checked to be sure that there is at least two inches clearance between combustible materials
and the chimney.
Third: Chimneys and chimney connectors shall be installed with the required clearances
(see installation clearance table). The connector should be sloped upwardsloward the chim-
ney and the connections overlapped upwards to prevent creosote leakage. A two inch clear-
ance shall be maintained where insulated pipe penetrates a combustible wall, unless it is tested
and approved for lesser clearances.
A non-combustible hearth must be provided. Most stoves have legs and allow airto pass
below; if the legs are not present, an air space below the non-combustible hearth must be
provided. Clearances vary with circulating and radiant stoves. In general, a non-combustible
shield should be installed with ventilation behind it for lesser clearances, no protection for large
clearances, and if the wall is a concrete foundation wall, a minimum distance may be allowed.
The following systems have been approved by the Construction Material Safety Board:
Permaflue, Air Krete, Smi Exterior Insulation and Finish System, Supaflu, Thermo Crete, and
IsoKaern. The code requirement for two inch air space is exempted from this type of lining
because of its high insulating and refractory qualities.
5
,�,eries 3 CB
I �2
0
Installation and Operation Instructions
JoTur
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.
Tested and listed by Inchcape Testing Services -Warnock Hersey of Middleton, Wisconsin.
Tested to UL 737, UL 1482, ULC S627. Test date, December 1, 1995. Report No. 13321-164.
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