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Miscellaneous - 66 LACY STREET 4/30/2018
/ 66 LACY STREET 210/105.D-0049-0000.0 \ Date.........�. .......................... �r; ;•. oo� TOWN OF NORTH ANDOVER O T PERMIT FOR WIRING • .: • ,S`4'�CHU5�t This certifies that ... ........................... has permission to perform .1,I--..1/L ......\,rA.................................................................................. wiring in the building of......... c.,x .. ....................................................................... at .��?. �....� . c.. .. ........... ............... h d ver,Mass. Fee. ..'�.............Lic.No. ....j �.��.....�....... .�.. . .................................... ELECTRICAL INSPECTOR Check4t � �� ff Conwwtzutm of Mamarl ttie& Official Use Only PermitNo. r• o./L'�1QiK't738T[L 0�✓"'LF8�eYUbL'e3 BOARD OF FIRE PREVENT IOM REGULA T IONS Ugev 1��and Fee Checked APP � R V�� leave blant: MR MUT TMC, ELECTROC A2,L 'WO All-,mrk to be performed in accordance w {MEC).5_ with the Massachusetts Electrical Code 27 CMR 12.00 �;, (PLI MSE RIUVT-rivaY OR 1'� -41 -IRT-0R 1,-u7 .0A , YJ 070 ����> CPI /.5 city or Tbiva a2 22t z c�ot/P To the ksnecim-of Mires. By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Lootion(Street Rz Number) C—j— ��slaer oz� � CQ-fiF/G �c�3 t�s oma✓ Owner's Address tpee, �C Y is this permit in con jun L Wife:a bufle-m gues=.a.='t? `des ❑ PT ® (Cheek Appropr92te Sox) Purpose _t TJzaI f c1,=a�Icr Ivo. Eris RgService 200 Amps 1,V 1 A 'o ts iovethe4e 3- Undg;.d❑ 1Jor , .0:meters i�Tenl Service cps I yoits €,'eFPM5-d M( �i• g �! !tel ?'ba�❑ 1d.Q%J Ia eters lumbar of Feeders:ane Ampachy Location end Nature of Proposed glecunica 1vorls: Completion Io.o ReeesseC Luminaires . . afte jtable mtu be T:'aitted b lite hi ecto r of 11"imse .o :ae)_ans tel €rasa'ormers 7?-VA- rzifl.cif s.ILf3 aiF•e yidtiefa 140.el of Tubs v3�ea ctGrs- i�/t its.3s 1T3FI?ir �'t:5 S� mi€�g X001 `aboue ❑ - ❑ ltvo.0z'�nae:gecy 1g t?rg 3ti. �RO I .*'/=units 1,410.of Receptacle Outlets RTo.of oil Bur- ler 1_s �LAR I into.of pones t I�Jo_of ST?hFelles No.01,02s Bulme:s i�?o.�=�e`aec on d I an{drai�i3' sites 1�T0.0-.F.arch s •� �l�Je,o'a"L�C.ox�.E:. Tons �I�IG.of Aierfling i'ae~liees No.of IRI z 11mose.sf3a'esP iie: : e1, ='vat ;tt acct-r fl?s neC{ Tot2is: iDetecflonl ,Te. Devices P/o.flf DishwashersSpace/A€•ea Heating 10"((1j _a,p g❑ Putt=etOal ? Y� Co�eetlo:t ❑ Offer Wo.of Dryers Hearing Appllanees Eeet ss=3'�ystea�zs: No.c_'Water No.flr Devices or Evuiva"_ent @atBrS `� MOW S$ �E32$8 N1�ir3:ab Saga Wo.of DmricLs 0-7 C-ai;lalent ;o. dEor assage BathtLbs l to.0_IYo s_s Tota:-= �'elecom unaca our i g. [ OTHM,i�: No.of Devices a1,E uiralent j Value -lttach additional detail ifdesired,or as required ky the Inspector of litres Estimated t alue of Electrical Work 0/0 0. 0 0 (When required by municipal policy.) Work to Star`: 1-(q 1 IS— Inspections to be requested in accordance ttI C Rule 10,and upon completion. Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operadoe coverage or its substantial equivalent. The unairsigned cer fles that such coverage is in rorce,and has m-dillbited proof of same to the permit issuing oi=atee CfCK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ {$pec= '-) d c°ltt�j y trader Jte pants mtd petz¢l re3 t pet.py,tfu#lite itjforrW io a OP,has appiiea ot_is'rate and conipieta MR11K NAME: !/t/1 r0¢fl— tf'CG�-t c/�� e- � c,e3 u-C.I'ic': Licensee: c v(--� e /L�/1L,..a-•t a a'� i=ts: r j (yapplicable,ewer"erenlpt"in rile license mtmber line) ,is '»U Add. ess; O t1 ,9 le h+ -t /Sig a s,^_s o.; 8'(c f1, "Per M.G.L.c.147,S.57-61,security urork requires Department of Public Safety"S"License: Lic.No. F am aware that the Licensee does not leave the liability insurance covera�Qe normally required by Iaw. By my signature below,I hereby waive this requirement I am the{cizeck one)[]oRter [0[�,741er/Agee€ c is ❑�on,�ner 5 8gent. $eienhone,1•�lfl. Lam_. .>t ^ B The Commonwealth of.z;. Massachusetts Print Form Department of Industrial Accidents j Office of Investigations i 1 Congress Street,Suite 100 ' Boston,MA 02114-2017 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/individuzl): I--- All"6J/7 GL e:6 7 P, I C1 L 5-16 t/ --r C Address: /�1y /60 )( 70' City/State/Zip: %10014-%lAl 1111f-0'1 Yj, hone#: (31,7f-- Are you an employer?Check the appropriate box: Type of project(required): 1.M-I am a employer with-- 4. I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. E]New construction 2.❑ I 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' 9. ❑Building addition [No workers'comp.insurance comp.insurance.'+ required.] 5. We are a corporation and its 10.[Z Electrical repairs or additions 3.❑ 1 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 employees.[No workers' 13.❑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. Iam an employer that is providing workers'compensation insurancefor my employees. Below is thepolicy andjob site information. Insurance Company Name: Policy#or Self-ins.Lic.#: (�g 1/✓��C/i �7 �0 Expiration Date: ©/S Job Site Address:_ CP City/State/Zip: 06b0l't AKJri,< 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 cert ud7tepa`," nd penattles ofperjury that d:e information provided above is true and correct Signature: Date: Phone#: 9 7 -7 - y Ogicial use only. Do not write in this area,to be completed by city or town officiaC City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: i r <� ®OMMONWEALTH OF MINE ® • ' ' ® MASSACHUSET aQara 0 EL E CTI3`►C I AN,S F ISSUE AS; S HE FOLLOWING' ,Q RSG JOULICENSE MAN ELECTRI RNEYCIAN ' r� KEVIN> R EMMETT �6 L r Pq BOX 794 � Z. M 1 OD L ETON .. %. , j•' /� { 37432 MA 01949-27 07/31/16 , 50777 Date.: ZV V� ...... I � L � 7 TOWN OF NORTH ANDOVER Off?i• -`; ••• 009 * * , PERMIT FOR PLUMBING t S / t��� This certifies that. -,. .. � VI���7 S , f �ua has permission to perform...... . ............................. plumbingin the buildings of............................................................................................. at...(,.P... ......... . '......� ......................North Andover, Mass. 7 Fee 4 A.T.....Lic. No............N...... ........... ! ...............................: ......................... ^ r, PLUMBING INSPECTOR Check# kv XU -72, /S on- 31415'' !MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK -� CITY �.�I MA DATE a _ i PERMIT#. JOBSITE ADDRESS OWNER'S NAME �;� POWNER ADDRESS _ TEL -US" FAX _ TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL ® RESIDENTIAL D PRINT CLEARLY NEW: DlRENOVATION:® REPLACEMENT:Q PLANS SUBMITTED: YES D NOD FIXTURES-1 FLOOR- BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OIL/SAND SYSTEM DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM 6 DISHWASHER DRINKING FOUNTAIN FOOD DISPOSER FLOOR/AREA DRAIN J .____-_.1 INTERCEPTOR(INTERIOR) KITCHEN SINK LAVATORY ROOF DRAIN _____J SHOWER STALL SERVICE I MOP SINK TOILET URINAL WASHING MACHINE CONNECTION WATER HEATER ALL TYPES WATER PIPING _ l OTHER f I I ............ INSURANCE COVERAGE: 1 have current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES O—NO 0l IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY 0� OTHER TYPE OF INDEMNITY 0 BOND 0 OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER D AGENT (0 SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all Peiflent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. 'f �� T PLUMBER'S NAME -- LICENSE# 7 I IGNATURE MP D JP 0 CORPORATION FJj# COMPANY NAME ADDRESS --� CITY , -- _---_- __._I STATE ZIPTEL FAX CELL EMAIL ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOXES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# PLAN REVIEW NOTES c d � � a The Commonwealth of Massachusetts Department oflndustrialAccidents 1 Congress Street,Suite 100 Boston,MA 02114-2017 "t www mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name(Business/Organization/Individual):�r �!/ •/ Address: City/State/Zip: Phone#: Are you an employer?Check the appropriate box: Type of project(required): am a employer with \.�: employees(full and/or part-time).* 7. ❑New construction `•L-1'l am a sole proprietor or partnership and have no employees working for me in 8. ❑Remodeling any capacity.[No workers'comp.insurance required.] 9. ❑Demolition 3.❑I am a homeowner doing all work myself.[No workers'comp.insurance required.]t ❑4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5. I am a general contractor and I have hired the sub-contractors listed on the attached sheet. ❑ 13.F1 Roof repairs • These sub-contractors have employees and have workers'comp.insivance.# 6.[_1 We are a corporation and its officers have exercised their right of exemption per MGL c. 14.❑Other 152,§1(4),and we have no.employees.[No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy infomiation. I Homeowners who submif'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-c'fi6ciors have employees,'they must provide their workers'comp.policy number. I am an employer that is pioviding workers'compensation insurance for my employees.'Below is the policy and job site information. c l Insurance Company Name: J//&Z Ila/I Policy#or Self-ins.Lic.#: S/��QQ�Qp� '�,l�/� Expiration Date: Job Site Address: City/State/Zip: .0&4 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Si ature: Date: Phon �92,57--_ k4nf -�Z0 3 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 5.Plumbing Inspector 6.Other Contact Person: Phone#: 1 Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their e1.mployees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall. enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority" Applicants Please fill-out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub=contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents foi•confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should'enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bums leaves etc.)said person is NOT required to complete this affidavit. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston,MA 02114-2017 Tel. # 617-727-4900 ext.7406 or 1-877-NIASSAFE Fax#617-727-7749 Revised 02-23-15 www.mass.gov/dia �>> ONWEALTH OF MASSACHUSETTS' BOARD OF PLUMBERS 'AN6 GASFITTERS y' ISSUES THE FOLLOWING LICENSE-= LICENSE AS A JOURN.EYMAN,PLUMBER J ES M TITUS 2 ' DUBLIN RD +y�� I?Woft MA o i 960-3545 32744 05/01/16. 215128 #' 3�75�/S Date. . ............ ....................... OF NORTh,� TOWN OF NORTH ANDOVER 9 PERMIT FOR WIRING s`SACHUsfc �I �D �! I.. .f � Thiscertifies that ...................................................... .................................................................... has permission to perform ....... �0^r!........ wiringin the building of.................f............................................................................................. at ................. :..... ...... 7'ZQ-p:.f........................ rth Andover,Mass. Fee( .:.0 ......Lic.No.� /.. ..... �Mr�Z 01 . . ....... ... a '1 INSPECTOR C'r{eck# 74 ��'` Coran,anweab!or,'Maa=1w.& Official Use Only . 2eFar$tnen:o156.&ruice3 Permit No. 177111 BOARD OF FIRE PREVENTION REGULATIONSOccupancy and Fee Checked [Rev.1/073 (leave blank) MPPL0r,rAT10ir\,S FOR P E RM I T T�, PERIL RM CLEC T R 0 C A L `AL0RK All urorlc to be performed in accordance with the Massaehusetts Electrical Code(MEC),527 CMR 12.00 (FI'EASEPR1NT YEffORY TPEALLBV_F0J "7y01\9 Dee: 3 I 9-//a()l5' Citi or Ti'ovvca of To the I73pector of Wh es. By this application the undersigned gives notice o f his or her invention to perform the electrical work described below. Location(Street&Number) (o G L.q C. 2 c-.'� Owner or=enant u\07; Telephone No. Owner's Address (n (_Cc Com{ cS7�Z L-2 7-IA161 , Is this permit in conjunction with a building pe_-nait? Yes No ❑ (Chech Appropriate Bos) Purpose of 3uildiag UffliLy�kEtthorl ati,n I'qo. Existing5crvice /04 Amps 1A0 la'`fU ijults Overhead Und ,e r g" ❑ No.os 1?sete:s / New Service Amps / Volts Overhead❑ iintigad❑ No.of Deters Number of Feeders anct Arnpacity Location and Mature of Proposed ilIeetricator2c: tA/l� Com ledon o the follbivittirtable tray be$salved bythen ector of li'ires Ne.of Recessed Luminaires 1.0 No.of Ceil.-Slsp.('Paddle)Fans No.oTransrl ers Total No.of,Luminaire Outlets NO.of g=ot Tubs Generators Y-VA < � 01 �No.of Luninalses SwtmnungFoolAir°Ye ❑ nergeucy tg nag gad. C-rad. / Units -3' No.of FAceptacle Outlets Qj No.of Oil Burners ��A'u_.ARTt/15 310.of hones No.of switches (p No.or Gas Burners o.of tZetect on and anit latiaa Devices No.of Ptnges � �No.of Air Cone. Tons JNo.of.A Ierang Devices ,ale Heat Ru Number eons xMT Fin of Self-Conzatned No.of Wase Disposer � Totals Detection/Aler isDevices No.of Dishwashers SpacelAres Heating 11M, Lori❑ Connection ED Other i No.of Dryers ? ea ng Ap liaaces ecus 5ys� s:r No.of L%ttnter No.of Devices or E4uivalert c� ` ,� i lo.a' i�lo.o: Data Wiring: eaters Signs Ballasts No.o-Devices or Equivalent No.I~ydromassage Bathtubs f No.of Me-1a-s Total Pi-P 1E'eletotnnttsnica�oats�iritig: _ To.off Devices or 1 uivaient ,---- OTHE,R: �Itlacli additional detail ifdesired,or ns required bz=the Inspector of Fl rtes Estimated Value of Electrical Work �,0�,dQ (Whea required by municipal policy.) �- Work to Stmt: o?(, I S Inspections to be requested in accordance with MEC Rule 10,and upon completion. MURANCE.COVERA E: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in foto.,and has uMiibited proof of same to the permit issuing office. CHECK ONE: INSURANCE E@. BOND ❑ OTHER ❑ (Specify.) I cardfy,under the pants and penalaw of per,jtary,that the v farmaiioti or,this trpplicafiori is trite and compJet& FIRNI INA E-: .1/latr &7 eL/v'i c/1-C -trvc(4 s L§C.No.: l5-7/9 Licensee: Alev(AJ 1? 6ilM977--- S3patura i,nC.IsiO.: I 7/ 9 (ljapplicable,eWr"exe rpt"in rite license number Ji,�e� Bus.Tei.No.; Address: 1✓0 7 �C 7 64t dd/ A� dLl.� D/��9 'Per M.G.L.c.147,s.o1-6I,security work r " „ A-It.Tel.No.: g 7Y-,rr8 15'6 31 ty requires Department of Public Safety S License: Lic.No. 01,VNER'S INSUP,AlvCg 57e'A+-T'1jR: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,F hereby waive this requirement. 1 am the(check one O mer/Agent ❑owner Q owner's agent Signature Telephone No. ffT Z >COMMONWEALTH OF MASSACHUSETTS • o FelMom M • BOARD OF EI»ECTRIClANS ISSUES,:THE FOLLOWING LICENSE AS A. REG JOURNEYMAN -ELECTRICIAN as KEVI N. R EMMETT i P �W d Z Lu PO80X: 794 MLAID LETON MA 01949-2794` 37432 >=.. 07/3.x/16 50777 . . � C COMMONWEALTH OF MASSACHUSETTS oorl ,; BfJAFtCI C3F E,LECTR I Cl ANS ISSUES THE .FOLLOWING .4ICENSE AS j a:? REGI STEI� D MASTER EL�,Tft I C I AN { A If,Vlli R EMMETT 1 f , W ;I f�, PO B,pX 794 ; I M l Gl LETON, -_A 01949-2794 15719 A 07/3 /1b 50778 i Location lQ(a c!<<, No. 00 Date • TOWN OF NORTH ANDOVER • • _ Certificate of Occupancy $ ,. Building/Frame Permit Fee $ -10 s Foundation Permit Fee $ rt � . Other Permit Fee r $ TOTAL $ Check#_Lr � (-2::� 25396 Building Inspector V r The Commonwealth of Massachusetts - Board of Building Regulations and Standards Massachusetts State Building Code,780 CMR,7"'edition Building Permit Application To Construct,Repair,Renovate Or Demolish a One-or Two-Family Dwelling ' Section For Official Use Only Building Permit Number: Date Applied: r7 Signature: Building Commissioner/Inspector of Buildings Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Asses�grs Map&Parcel Numbers 61t,icy STREET t"--A. C>oVE..R) N1.g (pxl 0 DOD l.l a Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) . Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Zone: Outside Flood Zone? Public❑ Private❑ Check if yes Municipal 13On site disposal system ❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record:. CRAIG =. 30el 1510" (�lo�G�J STRUT /tel.�ti.1DOV£1Zt 01EM6 Mame(Print) Address for Service: Signatud Telephone SECTION 3:DESCRIPTION OF PROPOSED WORKZ(check all that apply) New Construction❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) ❑ Alteration(s) ❑ Addition ❑ Demolition ❑ Accessory Bldg.❑ ' Number of Units Other )(Specify:_ �,a_l�•'[ Brief Description of Proposed Work2: 01 SECTION 4:ESTIMATEDCONSTRUCTION COSTS Estimated Costs: Item Official Use Only (Labor-and Materials 1.Building $ 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ ❑Standard City/Town Application Fee ❑Total Project Costa(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire t Suppression) $ Total All Fees: $ Check No. Check Amount: Cash Amount: 6.Total Project Cost: $4.` 0M.4 ❑Paid in Full ❑Outstanding Balance Due: Conservation Approval Required Dempster Permit Required O Yes O No - Will there be a dumpster at the work site: O Yes O No Signature: - Dumpster Permit Applied for on SECTION 5: CONSTRUCTION SERVICES 5.1 Licensed Construction Supervisor(CSL mss,,,, ��, ���� S Q�j -W jj, License Number J Expiration Date Name of CSL-Holder I `` List CSL Type(see below) LA Addres � Ty Description U Unrestricted(up to 35,000 Cu.Ft.) Sig ure Restricted 1&2 Family Dwelling ,q -1y2a• M Mason Only '1 RC Residential Roofing Covering Telephone WS Residential Window and Siding SF Residential Solid Fuel Burning Appliance Installation D I Residential Demolition 5.2 Registered Home.1m rovement Contractor(HIC) HIC Com any Name or HIC Registrant Name Registration Number Address •„ _ Expiration Date Signa arc Teieph e SECTION 6:WORKERS' COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152.§ 25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the Issua e of the building permit. Signed Affidavit Attached? Yes ......... No...........❑ SECTION 7a:OWNER AUTHORIZAVTONVO BE COMPLETED WHEN OWNER'S AGENTOR CONTRACTOR APPLIES FOR BUILDING PERMIT h C. LCA 752 rW$t P'1 n C) as Owner of the subject property hereby authorize ,5LA"- lReqq 1BLA1LX>E Z5 to act on my behalf,in all matters relative to work authorized by this building permit application. Signature of p v r Date SECTION 7b:OWNER'OR AUTHORIZED AGENT':DECLARATION I, "theforegioing ,as Owner or Authorized Agent hereby declare that the statements and informaf application are true and accurate,to the best of my knowledge and behalf. 1• . Print Name Signature Ownter or Authorized Agent Date Si ned nder the pains and penalties of ejury) NOTES: 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program and Construction Supervisor Licensing(CSL)can be found in 780 CMR Regulations 110.R6 and 110.R5,respectively. 2. When substantial work is planned,provide the information below: Total floors area(Sq.Ft.) (including garage,finished basement/attics,decks or porch) Gross living area(Sq.Ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" ROOFING & SIDING JOBS MUST ANSWER THE FOLLOWING: Number of squares: (Total roof coverage cannot exceed 2 layers: 780 CMR 3609.10.3 –� - 44 F.O. Box224 Suncook. U.-H 03275-0224 PHONE TeL (603) 300-6915 Fax NO3) '-0658 EMAIL ADDRESS SUBMITTED TOY n i �-CSI%? ! _ � . JOB NAME STREET-L.0 . `> C {?' _ -___-.____.._____ _ JOB LOCATION CITY,STATE AND ZIP_-- , ! 7s i JOBPHONE WE HEREBY SUBMIT i SPECIFICATIONSFOR:: .. �f1--, srtS1.-T - �--•—� i i. f..f -- ---------------- WE PROPOSE HEREBY TO FURNISH MATERIAL AND LABOR-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS;FOR THE SUM OF: C- DOLLARS($ PAYMENT TO BE MADE AS FOLLOWS: All material is guaranteed to be as specified.All workto be completed in a workmanlike manner •-' '. according to standard practices.Any alteration or deviation from above specifications Involving extra costs will be executed only upon written orders,and will become an extra charge over and above the / estimate.All agreements contingent upon strikes,accidents or delays beyond our control.Owner to AUTHORIZED carry fire,tornado and other necessary Insurance.Our workers are fully covered by Workmen's SIGNATURE v , Compensation Insurance. ACCEPTANCE OF' ONTRACT—THE ABOVE PRICES,SPECIFICATIONS AND CONDITIONS ARE SATIS/TORY D ARE REBY ACCEPTED.YOU ARE AUTHORIZED TO DO HE ORK:AS SPECIFIED.PAYMENT WILL BE MADE AS OUTLINED ABOVE SIGNATURE DATE_ _ SIGNATURE Cons t ru ction Stj pe rsrisor CS-086380 JASON A TARDUT . 15 NOTRE DAM AVE JL ALLENSTOWN NH 03275 11/03/2013 �� -boa .Y.. e./2�raaa�ce�. Office of Consumer Affairs & Business Regulation HOME IMPROVEMENT CONTRACTOR Registration: :,:: 'j41507 Type: Expiration;-, -4)��014 Ltd Liability Corpc., ........ .......... ..................... ........................... ............ .... SUN RAY BUILDFE .......... :.:-�.......... JASON TARDIFF 15 NOTRE DAME ALLENSTOWN, NH 03 Undersecretary NORTH ® of No. �Y.. tiM,4• f o� , dover, Mass.,0 M_ LAKE COC AKE HICHEWICK 0RATED BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System t BUILDING INSPECTOR . , ...............................................THIS CERTIFIES THAT................. i�... .S............ ............ Foundation has permission to erect...... .....:........................... buildings on ..........&. .......... a. ..........C. ..�r.................... Rough to be occupied as. T...........M. 4. chimney provided that the person cepting 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 CONSTRUC SIARTS Rough ............. ... ......................... ................................. Service BUILDING 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 FIREE_DEPARTMENT Until Inspected and Approved by the Building Inspector. TBurner Street No. SEE REVERSE. SIDE Smoke Det. SUNRA-1 OP ID: TL CERTIFICATE OF LIABILITY INSURANCE DAT12114DtYYYY) 12!14111 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. PRODUCER 603-536-8200 NA ERCT Insurance24.com,Inc. PHONE P.O.Box 480 603-536-2206 IC No E A1C No: Plymouth,NH 03264-0480 E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC k INSURERA:Nautilus Insurance Company INSURED Sun-Ray Builders,Inc. INSURERB: J &L Chimney Works, LLC P.O.Box 224 INSURER c Suncook,NH 03275-0224 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAYHAVE BEEN REDUCED BY PAID CLAIMS. POLICY EXP LTR TYPE OF INSURANCE 1 SR POLICY NUMBER MMIDDY EFF MMIDDIYYYY LIMITS GENERAL LIABILITY EACHOCCURP.ENCE $ 1,000,00 A !EITLAIMS-MADE ERCIAL GENEF.AL UAEIUTY NN133522 07!15/11 07/15/12 pEMIES E '6 100,000 D�lOCCUF' MED EXP(Any one person) $ 10,00 — PERSONAL£.ADV INJUPY $ 1,000,000 GENERALAGGREGA7E $ 2,000,00 IEN'L AGGPEGA.TE LIMIT APPLIES PER I PRODUCTS-COMP/OP AGG $ 2,000,000 I1 I c..-,LICY I X FFr7 L0 $ I AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accidentl $ AI1, AUTO BODILY INJURY(Per person) $ aUTO',S1'NED C'TEDULED BODILY INJURY(Per accident) $ n LII ( NON-OWNED PROPERTY DAMAGE HIR EDALITOc .AUTOS Peraccident $ I $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR I I CLAIM$-MADE AGGREGATE $ DED PF--=_,1.iTION$ J._.� WORKERS COMPENSATIONVJC STATU- OTH- AND EMPLOYERS'LIABILITY YIN y AN' rc•f-:OPRIETORIPAP.TNEF,'/EXEC=UTNE NIA E.L.EACH ACCIDENT $ OFPII"ERIMEMSEP,EXCLUDED% (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE R I.�-es,describe under DESCRIPTION OF OPERATIONS bele. E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS]LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarl(s Schedule.if more space is required) . CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts Department of Industrial Accidents ice of Invadgations 600 Washington Street Boston,MA 02111 www.massgov/dia Workers', Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers A licant Information Please Print L bl Name.(Business organizatiodtndividual): Address: 3 ty/State/Zi : /U �'�� Phone#: CiLgl Are you an employer?Check the appropriate box: Type of project(required): 4. 0 I an a general contractor and I 6. New construction I.❑ I am a employer with"MpWiceand/or par-.* have hued the sub-contcact&s listed on the attached sheet. 7. Remodeling 2. I am a sole proprietor or partner- .These sub-contractors,have 8. 0 Demolition slip and have no employeesemployees and have workers' _working for me in any capacity comp.insurance.: 9. ❑Building addition [No workers'comp.insurance 5 We are a corporation and its 10.(]Electrical repairs or additions required.] offrcers have exercised their l l.Q Plumbing repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 12.[]Roof repairs Myself [No workers comp. c. 152,§1(4),and we have no insurance required.)t employees.[No workers' 13.N-01her 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 an work and then hire outside contractors must submit a new affidavit indicating such. =Connectors that check this box mast attached an additional sheet showing the name of the sub-cOntr8mrs,and state whether or not those entities have employees. if the subcontractors have employees,they must provide their workers'comp.policy number. .jam an employer that is providing workers'compensation insurance for my employees. oeww is sur passcy j���••� information. Insurance Company Name: Policy#or Self-ins.Lic.M Expiration Date: �f , Job Site;Ae)diess: c� City/State/Zip:1�A��^� �l Attach a copy of the workers'comp ation 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 ORDERand a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification I do hereby certify under the pains and penalties of perjury that the information provided above is true and correc. Si atute: Date: Phone#: 7�2? ficial use only. Do not write in this area,to be completed by city or town official, i City or Town: Permit/License# Issuing Authority(circle one): L Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Phone#• Contact Person: i y 4 x w Y !3 York Insert Operation & Maintenance Manual Table of Contents ST. CROIX FEATURES.......................................................................................2 INSTALLATION..................................................................................................3 PREVENTING CHIMNEY FIRES.....................................................................3 SATISFACTORY PERFORMANCE.................................................................3 PelletFuel...............................................................................................................3 AddCorn to the Mix..............................................................................................3 OPERATING INSTRUCTIONS.........................................................................3 Control Board Features.............................................................................4 Thermostat Function—How does it work?.............................................5 Pre-Lighting Instructions..........................................................................6 LightingYour Stove ................................................................................. 6 Shuttingthe Stove off............................................................................... 6 DiagnosticFeatures....................................................................................6 SafetyFeatures...........................................................................................7 CombustionAir Damper ......................................................................7-8 FlamePattern Characteristics..................................................................8 MAINTAINING THE STOVE ............................................................................9 DailyMaintenance ........................................................................... 10-11 PeriodicMaintenance ...................................................................... 11-13 YearlyMaintenance ......................................................................... 13-14 SAFEOPERATION........................................................................................... 14 TROUBLESHOOTING AND FAQ............................................................ 15-19 PARTSLAYOUT..........................................................................................20-22 WARRANTY.......................................................................................................23 1205 Dear St. Croix Pellet Insert Owner: Congratulations! Your purchase of a St. Croix pellet insert places you among a select group of individuals who have demonstrated their concern about residential heating efficiency and our environment. This owner's manual is designed to help you obtain maximum benefit from your St. Croix wood pellet stove. Please read this manual in its entirety BEFORE operating your pellet stove. During the manufacturing process every effort has been expended to ensure that each St. Croix pellet insert meets the highest quality standards of material and workmanship. Here are some important aspects of pellet insert installation and operation, which you must observe in order to obtain maximum comfort and safety from your new St. Croix wood pellet stove. 1. Have your new St. Croix pellet insert installed by trained, qualified personnel. 2. Use only clean, dry quality wood pellets that are known to burn satisfactorily in your stove. 3. Faithfully adhere to the maintenance program described in this manual. Thank you for selecting a St. Croix pellet insert as the environmentally preferred answer to your residential heating needs. SAVE THIS OPERATIONS AND MAINTENANCE MANUAL York Operations Manual Page 1 York Insert Bay Front Pellet Insert Features: 45 Lbs. Hopper f al f � �� Digit Scra er Te Co and Control Bo P With Rod � �f Diagnostic Features Exclusive Large y g _ ,�. _. � .. ccSmartSta t» Viewing y r Fully Automatic GlassAuto Ignite WithNA NA Air System H 7 ,w 1 � �e �Z �, f Wash Versa Grate . S y �/ E � stem System „n 3 Tray Ash Pan System with Quick Release Latch York Operations Manual Page 2 Operation and Maintenance York Insert Pellet Stove CAUTION: Operate this unit only with the fuel hopper lid closed. Failure to do so may result in emission of products of combustion from the hopper under certain conditions. Maintain hopper seal in good condition. INSTALLATION Contact your dealer for more information on APFI Proper installation is essential for safety,effective approved wood pellet fuels. operation, warranty coverage, and insurance NOTE: Pellets with excessive sawdust should be requirements and to meet local building codes. screened by sifting with 1/4" mesh screening. Installation requirements are described in the Installation Manual included with your new Store Pellets under cover on a wooden pallet or other stove. methods to ensure they do not become rain soaked or absorb moisture from damp or wet floors. Do not PREVENTING CHIMNEY FIRES store pellets within stove installation clearances or within the space required for ash removal. Chimney fires can be prevented by properly The stove is not warranted against damage caused by operating the stove and by periodic inspection poor pellets, incorrect operation, poor maintenance and cleaning of the chimney. When wood is or incorrect installation. burned it produces tar and other organic vapors, which combine with expelled moisture to form ADD CORN TO THE MIX creosote. The creosote vapors condense in the relatively cool chimney flue associated with a The Prescott Series is approved to burn a mixture of slow burning fire. As a result, creosote residue pellets and corn (maximum 50% corn). The accumulates on the flue lining. When ignited this Thermostat Switch should be set to the Manual creosote can result in an extremely hot chimney position. (See Fig. 2 on page 5) Operation of the fire. stove doesn't change when burning a mixture of pellets and corn. The burn pot will need to be The chimney and chimney connector should be cleaned on a daily basis, using the "Pot Scraper inspected at least once every two months during Tool" shown in figure 5 on page 9. Use the Pot the heating season to determine if a creosote Scraper Tool to remove any clinkers that build up build-up has occurred. If a significant layer of because of the corn when needed. For more creosote has accumulated (3 mm or more) it information, read the Daily, Periodic and Yearly should be removed to reduce the risk of a Maintenance section towards the back of this chimney fire. Use of an appropriately sized manual. chimney brush or the services of a professional chimney sweep are recommended. OPERATING INSTRUCTIONS SATISFACTORY PERFORMANCE A different type of heater. The pellet stove is neither a cord wood stove nor a furnace. Its operation and The keys to satisfactory performance are: proper maintenance differ from the traditional wood stove. operation of the stove, diligent maintenance and FOLLOW THESE OPERATING INSTRUCTIONS burning only dry, clean,quality wood pellets. EXACTLY AS STATED TO ENSURE SAFE AND PELLETS RELIABLE OPERATION. 1. Carefully read this "Operation and Maintenance" Clinkers and ash are a by-product of pellet manual in its entirety BEFORE lighting your stove combustion and are not caused solely by your for the first time. stove. Stove performance can be quickly and 2. Obtain final inspection and approval of severely reduced if poor quality pellets are used. installation from local building officials. York Operations Manual Page 3 3. Carefully clean all marks off the gold plated The Control Board controls all functions of the Stove by parts before the first fire is lighted. Use a soft monitoring sensors that are in the system. These sensors cloth and a "Windex" type cleaner. Caution: serve 2 purposes. Never use an abrasive cleaner on any plated or painted parts of the stove. a. General Operation of the Stove. 4. Have your dealer demonstrate all the opera- b. Safety Features, to shut the unit down in the tional and maintenance steps necessary for proper event the sensors detect a problem in the unit. use of the stove. Sign and return the warranty The Control Board also has Diagnostic Capabilities to card,to the address listed on the back page. help in diagnosing 3 areas in the Stove.These areas are: 5. Some odors may be given off during the first 1. High Temperature Limit. few hours of burning during initial break-in. These odors are normal and not harmful. 2. Proof of Fire Sensor However, ventilating the room until the odors disappear is recommended. 3. Vacuum in the Firebox 6. The stove will become HOT while in A closer look at the Control Board on page 5, figure 2 operation. Keep children, clothing and furniture will explain how the board works. There are five buttons away from all stove surfaces. WARNING:Direct labeled 1 through 5, a slide switch labeled 6 and a LED contact with the stove while operating may Light bar with 5 Heat Settings. The LED Light bar is also cause skin burns. used during the Diagnostic process, see page 6 and 7 for more details. 7.To avoid the possibility of smoke and/or sparks entering the room always keep firebox and de- The buttons on the board function as follows: (Refer to Figure 2. The touch pad buttons and Slide Switch are ashing doors closed whenever the stove is labeled with the white numbers 1 through 6) operating. 1. The Heat Level button (1) will advance the 8. A certain amount of carbon monoxide may be setting between level 1 and 5. Once you reach level produced within the stove as a by-product of combustion. All exhaust vent connections must 5, it will drop back to level 1. Each level has a LED light to indicate where the board is set. be sealed with RTV silicone to assure a gas tight seal. Any leaks into a confined area caused by 2. The On/Off button (2) turns the Stove On and faulty installation or improper operation of the Off. It will also reset the board after the board has stove could produce dizziness, nausea and in sensed a problem and is flashing a Diagnostic code. extreme cases,death. 3. The auger button (3) will allow the customer to 9.An outside source of combustion air is required manually auger pellets into the burn pot on start up on all mobile home installations. If room air is when needed. This is particularly helpful in priming used to supply combustion air, room air the Auger Tube when it is empty starvation, operation of exhaust fans and icing of air vents can adversely affect proper stove 4. The Draft Trim button (4) allows for operation. If these conditions exist, outside air adjusting the Exhaust fan voltage on Heat Level 1 should be used. only. Push the button and the all of the LED Lights in the light bar will flash once. This decreases the 10. Smoke detectors, installed in the same general Exhaust fan voltage approximately 5 volts below the area as the stove, may be activated if the stove default setting.Push the button a second time and all door is left open and smoke is allowed to enter of the LED Lights in the light bar will flash twice. the area. This decreases the voltage approximately another 5 volts. Pushing the button a 3rd time will reset the Control Board Features voltage to the default setting. This adjustment is READ "FREQUENTLY ASKED QUESTIONS" available to fine tune the #1 Heat Level draft ON PAGES 15-19 BEFORE OPERATING THE setting only.This would only be used in the case the STOVE. Stove was hooked up to a tall Vertical Chimney (see point 9 on page 18 for more information) York Operations Manual Page 4 c. The first and fifth LED lights indicate the#1 High setting. (1.75 second on time) This will produce the most heat available on the #1 setting. This is helpful in keeping the glass a little cleaner when burning on low. ` t"" The adjustments described in points 4 and 5 �M�: iii, �� remain in effect as long as the unit is plugged in. If the unit gets unplugged or if there is a power failure the settings are lost and the adjustments ' would need to be reset. ` Thermostat Function—How does it work? r 6. Thermostat Slide Switch. Use this switch to change the Operations mode between a Via Manual Mode, T-stat Mode or a fully F Automatic "SmartStat"Mode. a r: Manual Mode The stove is controlled by the J. x control Board and the operator, no thermostat is �� involved. T-Stat Mode — This is where a thermostat controls a the stove, but the stove never shuts down. In this mode the stove will advance to the Heat Level that �� � �� has been selected when the thermostat calls for heat and drops to the #1 Heat Level and pilots when the .rea thermostat doesn't call for heat. y d y SmartStat Mode—How does it work? The SmartStat Function on a St. Croix Pellet stove is the way a St. Croix operates as a Fully Automatic stove. A stove operating as a Fully Automatic stove Figure 2 works great when constant heat isn't needed. The 5. The Feed Trim button(5) will allow the Fuel stove lights when heat is needed and shuts off when feed rate to be adjusted on Heat Level 1 only. it isn't needed. However this is not the way to Heat Level 1 should be seen as the Pilot setting of operate a stove once the Heating Season arrives. the Stove, when operating on a Thermostat. Then a constant source of heat is what you will be Pushing the Feed Trim button (5) will switch looking for. This is where the "SmartStat"puts the between the different adjustments. Heat Level St. Croix in a different category. The stove operates one can be adjusted in the following ways: on a Thermostat and once the heat demand has been met the stove will drop into the #1 Heat Level and a. The first LED only indicates the Normal pilots there for one hour. If the thermostat doesn't #1 setting. (1.5 second on time). This is call for heat during that one-hour period, the stove the default setting. will shut down and wait to re-light itself when the thermostat calls for heat again. The control board b. The first and fourth LED lights indicate automatically switches back and forth between a the#1 Low setting. (1.25 second on time) "Piloting Thermostat System" and a "Fully This will reduce the heat output on the#1 Automatic Thermostat System" based on how often setting. This setting will also create more the thermostat calls for heat. This eliminates the On buildup on the glass. (See point 9 on page —Off cycle of an Automatic stove, once the Heating 18) season arrives. York Operations Manual Page 5 Pre-Lighting Instructions P.O.F. the Igniter shuts off and the stove has started successfully. When lighting your stove for the first time,or any time you have run out of Pellets,you will need to d. If the board fails to sense P.O.F. it will repeat fill the hopper. Pellets are fed from the hopper to the previous step and continue feeding pellets on the burn pot by an auger. A high torque motor the#1 setting for 5 more minutes. that is capable of doing SERIOUS harm to e. The board will check for P.O.F. one more time. fingers drives the auger. Keep fingers and other If the board still fails to sense the Proof of Fire objects away from the auger. switch,the stove will go into "Safety shutdown" (See Diagnostic Features in the column below). WARNING: The Auger can start at any time while the stove is running If this happens, repeat steps 1 through 4 from the section on Lighting Your Stove. WARNING: The Ash Pan Door must be in CAUTION: NEVER ADD FIRE STARTER TO the latched position during normal A HOT STOVE. operation. Shutting The Stove Off(Refer to Figure 2) WARNING: The Firebox Door must be in 1. Press the On/Off switch (2) once; the lights will the latched position during normal go off and the fire will go out in a few minutes. The operation. board essentially goes into"Safety shutdown". 2. As long as the Exhaust Temperature within the Lighting Your Stove.(Refer to Figure 2) stove remains above 110°F, the Room Air Fan, the Combustion Exhaust Fan and the Versa Grate motor 1. Make sure there are pellets in the hopper and will continue to run. Once the P.O.F. switch drops the viewing door and ash pan door are closed. out the Combustion Fan runs for another 10 minutes and finally the stove shuts down completely. 2. Push the On/Off button on the control board. 3. NEVER unplug the stove to shut it off. Doing so (Button #2) may cause a significant amount of smoke to enter At this point all that needs to be done is to the room. monitor the burn pot to make sure the stove starts Diagnostic Features of the Control Board up properly. Once the On/Off button has been pushed the Start Up program takes over. The #2 LED and the #3 LED lights on the LED The Start up Program works as follows: Light bar as show in Figure 2 will flash to give a diagnostic code to help in diagnosing problems that a. The Combustion fan and Room fan come on may occur. at high speed and the control board checks to make sure the Vacuum switch locks in. (See These conditions fall into 2 categories: Diagnostic features in column to the right.) a. Heat related issues. b. When the board senses the Vacuum switch b. Vacuum related issues. the Combustion fan drops to the #1 setting and the Room fan shuts off. The Diagnostic Lights flash as follows: c. The Igniter and the Auger come on (the The Proof of Fire switch.This switch will sense Auger only runs for 2 minutes). The stove the temperature of the Exhaust rising during start will typically light in the first 3 - 4 minutes. up. If the Exhaust temperature does not reach After 5 minutes the board checks for "Proof 110 degrees F, or if during use the temperature of Fire" and starts feeding pellets on the #1 drops below 110 degrees F, the Stove will go setting (See Diagnostic Features in the into "Internal Alarm" and the Auger will quit column to the right). Once the board senses feeding fuel. Once the stove completes the York Operations Manual Page 6 safety shutdown, the #3 LED will start 2. Proof of Fire switch also called the P.O.F. blinking. (See Figure 2 on Page S and point 3 This senses the temperature rise in the exhaust on page 1 S) system. The switch is "Normally Open" and closes the circuit at 110 degrees. The Stove will 1. The High Limit switch. This sensor will shut down if temperatures above 110 degrees F sense if the unit reaches temperatures that are are not sensed during start up or if the too high for normal operation. If this happens temperature drops below 110 degrees during the Auger will quit feeding and the#2 and#3 normal operation. LED lights will flash simultaneously. (See Figure 2 on Page 5 and point 4 on page 16) 3. Vacuum switch also called the Negative 2. The Vacuum Switch - For the stove to pressure switch. When the stove is turned on operate, the Firebox needs to be sealed. the Exhaust fan will create a negative pressure in During the first 30 seconds after the stove has the firebox. The control board continually been turned on the Control Board will check checks to see if Negative Pressure (vacuum) is if the switch senses negative pressure present during operation of the Stove. If the (Vacuum) in the Firebox of the stove. If there exhaust venting system becomes clogged or is no negative pressure, the stove will shut obstructed, the firebox door or ash pan door are down and the #2 LED will start blinking. left open or the exhaust fan quits working the (See Figure 2 on Page S and point 2 on page control board will go into "Safety shutdown". 15). There is a 60 second window to allow for cleaning the glass and removing the clinker "Power Reset". If the board becomes before then Stove shuts down. This is sufficient unresponsive you must unplug the stove, wait 10 for the Daily Maintenance seconds and plug the stove back in to reset the board. The St. Croix Pellet Stove has been Safety Tested by an accredited,independent laboratory. "Internal Alarm". When the control board becomes unresponsive, the control board is in Internal Alarm. The control board has sensed one WARNING: These safety features are of the Safety sensors. This may cause the stove to designed to protect life and property. Bypassing these features voids all warranties go out. In some cases, after waiting and the safety listing of the stove. approximately 45 seconds the stove will start responding to the control board again. Many times,the cause of this is a change in the vacuum inside the stove. This may be caused by excessive Damper Adjustment wind, opening the Firebox door or opening the Ash Pan door. The control board will monitor the When burning pellets make sure to check for the vacuum switch and resume normal operation if formation of creosote in the unit and venting the vacuum returns to normal. system. Constantly running the stove on a low setting with too much combustion air may cause Safety Features creosote to form. Burn pot temperatures can be 1. "High Limit" switch", an overheat "too cool" when burning on low with too much safety switch will shut off the fuel feed if the draft. Stove reaches temperatures above normal Adjusting the Damper may take a little time and operating temperature. This is a "Normally patience, but only needs to be done once. After the Closed" switch and is part of the Fan limit damper has been adjusted to the venting system in control. If the High limit switch trips several your home,the control board will do the rest. times, the problem in the Stove must be The purpose of this damper is to adjust combustion diagnosed before the Stove is put back in airflow to match the characteristic of each specific service, (Defective Room Fan, dirty Room air inlet and chimney configuration. The damper has Fan, dirty Return Air Filter, defective Fan been preset at the factory and is about 80% closed. Limit Control or possibly a bad Control This setting will work with most installations. Tall Board) York Operations Manual Page 7 i i vertical runs might need the damper to be closed The equivalent of a teacup of unburned pellets a day a little. To adjust the damper, use the Damper in the ash pan is considered normal. knob on the right side of the insert,just above the control board (See Figure 3 and 4). To make an Flame Pattern Characteristics adjustment, turn the knob clockwise to close the damper and counter clockwise to open the Correct Flame Pattern - Bright yellowish-white damper. The knob only turns 90 degrees. Do not flame with a brisk movement, having sharp pointed move the indicator more than 1/16" at a time. end tips extending up towards the Heat Exchange After making an adjustment wait at least 15 Tubes while forming a fan-like shape. Small minutes to see how the burn pot reacts to the amounts of ash and some live sparks being blown change. Additional Draft Adjustments can be out from the Burn Pot area is considered normal made for Heat Level 1 by using the"Draft Trim" operation. button on the control board (See point 4 on page 4). Adjusting the damper during the break in Incorrect Flame Pattern - Dark orangish-brown period is very important (See "Preventing flame with a lazy movement, having black smoky Chimney Fires" on page 3). Break-in requires end tips curling up and over the Heat Exchange the burning of 15 bags of pellets or continuous Tubes while forming a fireball-like shape. Some Ash burn for two weeks. If during the initial break-in or Live Sparks not being blown out from the Burn period you experience difficulty keeping the Pot area is considered abnormal operation. stove burning or there appears to be an excessive Extremely black soot forming on the ceramic glass amount of burning pellets being evacuated from surface is a sign of very poor combustion (not the burn grate, it may be necessary to close the enough combustion air) and should not be damper some more. Once the damper is adjusted, overlooked. At the other end of the spectrum; an the stove will run fine without having to make a extremely brisk flame which blows large pieces of change to the damper setting, unless the stove is live coal out from the Burn Pot area and causes run on 5 for extended periods of time (See stubborn shiny black build-up on the glass (too "Flame Pattern Characteristics" in the column much combustion air)is also considered undesirable. to the right). It is normal for ash and some sparks to be continually evacuated from the burn If you experience problems adjusting the stove grate. This is how the grate continuously cleans during the Break-In Period,contact your dealer. itself. ® DAMPER KNOB a FLEXIBLE 0� DAMPER ® CABLE 0 0 0 e FLEXIBLE DAMPER CABL Figure 3 Figure 4 York Operations Manual Page 8 MAINTAINING THE STOVE Remember, cleaning frequency may change dramatically from one fuel to another. Pellets with high ash content or that have increased amounts of The stove requires a minimum amount of daily impurities or high moisture content will require maintenance. Required maintenance depends more frequent cleaning. largely upon the quality of pellet fuel burned and the rate of burn. The amount of daily When you first operate your stove or whenever maintenance will increase if fuel quality you change fuels check to determine needed decreases and/or the burning rate of pellets cleaning frequency. increases. The Versa Grate System — First, let's become NOTE: FAILURE TO KEEP YOUR STOVE familiar with the burn system in a St. Croix Pellet CLEAN, AS DESCRIBED IN THIS stove. The system in the York Insert is a little MANUAL, COULD RESULT IN POOR different than in the Freestanding models (See Fig 5 OPERATION, INEFFICIENT FUEL below). There is a 2-piece burnpot. The top Part is USAGE AND A POSSIBLE SAFETY called the "Grate Weldment". This sits on top of HAZARD! IT IS YOUR RESPONSIBILITY the "Shaker Plate". This in turn sits on top of the TO DETERMINE NEEDED MAINTE- "Shaft/Cage Weldment" and is held in place with NANCE FREQUENCY. the "Spacer" & "Self Locking Twist pin". The Shaft/Cage weldment is moved towards the front of the stove and then towards the back of the stove by All models are equipped with the Versa Grate the "Cam" that is connected to the "Versa Grate System (see Figure 5 below). The benefit of this Motor". This motion is constant while the stove is feature is that the stove can operate for longer in operation. The only parts that may need to be periods of time,with most fuels,without the grate removed for cleaning purposes during the Daily or requiring cleaning. If the flame becomes dark Periodic Maintenance are the "Grate weldment" and orange, is accompanied by black smoke or burns the "Shaker Plate". The holes in the burnpot will get with a lazy motion-it's time to clean the grate. plugged with use and should be checked regularly. POT SC APER GRATE WELDME:NT SHAKER PLATE: VERSA CRATE MOTOR SELF LOCKING SPACER � TAN IST PIN FRONT HUSHIN(: VERSA CRATE MOt NF ASSEMBLY ASSEMBLY WITH REAR IIS SHIN(r VERSA GRATE SPRING CAM U 0 � ®• 000 ° SH,YFTrCAC:E WELL)1fENT Figure 5 York Operations Manual Page 9 Daily Maintenance CAUTION: NEVER ADD FIRE STARTER TO 1. Check Grate Weldment and Shaker Plate (See A HOT STOVE. figure 5)to determine if holes are plugged. Clean 2. There are 3 separate ash pans (See figure 7)in the as needed. With proper precautions the grate may York insert. Be sure to empty the center ash pan be partially cleaned while the stove is hot.Follow before it is allowed to plug the burn grate. If stove is these steps: burning with a lazy flame be sure to check the center ash pan. Check Ash Pans frequently to CAUTION: THE DOOR AND FRONT PART determine how often they need to be emptied. OF THE STOVE WILL BE HOT. DO NOT NOTE: Do not use a vacuum cleaner for this TOUCH ANY PART OF THE STOVE THAT purpose. Hot coals may cause your vacuum filter to IS HOT! catch fire. Place ashes in a metal container with a a.Wear a leather glove that covers the lower arm. tight fitting lid. The closed container of ashes should be placed on a noncombustible floor or on the b. Turn the Stove to Heat Level 1 and allow the ground, well away from all combustible materials, flame to burn down to a low burn. pending final disposal. If the ashes are disposed of by burial in soil or otherwise locally dispersed, they c. Open the firebox door slowly to prevent should be retained in the closed container for at least drawing ash or odors into the room. two days until all cinders have thoroughly cooled. To access the ash pans rotate the "Quick Release" d. Use the "scraper" provided to move the ash pan handle 90 degrees away from the stove (See burning pellets to one side of the grate, leaving Figure 6) and tip the ash pan door out 45 degrees. the ash in the bottom of the grate.(See Fig 5 &6) This allows the ash pan door to lift away from the e. Rake the ash& clinkers out over the grate into stove and be set aside. Empty Ash pans one at a time the ash pan. into a small container. When replacing the ash pan door remember to tip the door at a 45-degree angle f. Rake the burning pellets across the bottom of as shown in figure 7 before placing the Ash Door the grate. Hinge Points, small half moon notch in lower corners of the ash pan door, on the hinge pins (see g.Close the door. figure 7). Press the door into the pins and rotate up h.Re-select the desired heat setting. at the same time. Rotate the handle 90 degrees to latch ash door. TUBESCRAPER . WOW o� POTSCRAPER 0 0 ASM PAN DOOR ROTATE HANDLE,90 DEGREES AND PIVOT DOOR DOWNI AND sa. LIFT'UP TO REMOVE °QUA To reinstall the Ash Pan Figure 6 Door see fig.7 on page 11 York Operations Manual Page 10 O VT �0 0 HINGE TIN c a o�r HINGE TIN \ A.SII TANDOOR HINGE t,om'r Press the door into the pins and rotate up at the same time. Rotate the handle 90 degrees to latch ash door Figure 7 3. Once or twice daily pull the Heat Exchange 5. Burn the stove at the HI fuel setting for at Tube Scraper(See figure 6) out and back to clean least 20 to 30 minutes each day. This helps keep heat exchange tubes. Failure to operate the tube the glass, brick panels and firebox area clean. A scraper daily may result in poor combustion and daily high burn also aids in maintaining the loss of heat output. This should be done when the overall efficiency and performance of the stove. stove is cool or operating on the low temperature setting. Periodic Maintenance 4. Clean the Glass. The rate of burn and the quality of fuel will determine how often the CAUTION: Periodic maintenance should only be window needs cleaning. Prolonged burning at a done while the stove is shut off and cold. slow burn rate will result in the need for more frequent window cleaning. Burning poor fuel also 1. Empty the ash pans (see figure 6). The frequency increases the need to clean the window. Cooling of cleaning the ash pans will depend on the quality the stove and wiping the window daily with a and amount of pellets being used. Carefully check to cloth or paper towel will normally keep the make sure the bottom hinge pins are engaged after window from accumulating difficult to clean closing the ash pan door. residue. Use of a glass cleaner ONLY permitted when the stove is cold. Tip: Dip the damp towel 2. Clean the Ash Traps. The York Insert has 2 in the ashes to remove stubborn buildup on the exhaust cleanout covers (see figure 8) located below glass. the rear brick panel. IT IS CRITICAL THAT YOU KEEP ASH CLEAN OUTS CLEAN FOR CAUTION: Do not slam the door. Do not SATISFACTORY PERFORMANCE. Remove operate the stove with a broken or cracked covers and clean regularly. To access the Ash traps for the first time remove the shipping screws that glass. Replace only with heat resistant attach the Decorative Grates on both sides and ceramic glass supplied by the manufacturer. discard them.Remove both side grates and pull York Operations Manual Page 11 i ASH CLEANOUT COVERS A i e i r a 0 RE181C)" DISCARD DECORATIVE SCRLWS GRATES Figure 8 the bottom of the ash trap covers towards the 4. Remove the baffle and clean the ashes that front of the stove. This will allow the covers accumulate on a regular basis. Once a month or to slide out of the slot that holds them in sooner, depending on the quality of fuel being place. Vacuum area behind the covers used. regularly and do not allow area to become plugged. If stove is burning with a lazy flame be sure to check the ash traps. Frequency of cleaning Ash Traps depends on the amount of fuel being burnt and the - quality of the pellets. Fuel with low ash content is recommended. Failure to clean the ash traps can cause the stove to �eo become plugged with fly ash and could result in a Safety Hazard. 3. Clean holes in the Grate Weldment and Shaker Plate at least weekly. Remove the BAFFLE SITS ON burn grate and use a small metal object to TOP OF THE SIDE clean out plugged holes (See figure S). BRICK PANELS Figure 9 York Operations Manual Page 12 To remove the baffle (See Figure 9), lift the and ash traps behind the ash pan. (To locate the baffle and move it towards the front of the ash traps see Figure 8 on page 12) stove. The baffle rests on the side brick in the stove and is not attached with any fasteners. 2. The exhaust system should be thoroughly Clean the baffle on a regular basis. cleaned at least annually. Call your dealer for Frequency of cleaning depends on amount of this service. fuel being burnt and the quality of the pellets. 3. Oil the Damper control shaft and the holes Fuel with low ash content is recommended. in the 2" tube, to make sure the mechanism Failure to clean the baffle can cause the moves freely (see figure 10). stove to become plugged with fly ash and could result in a Safety Hazard. �- 5. Periodic cleaning of the exhaust system is :�;•_`-- required. Under certain conditions creosote ^ e buildup may occur rapidly. Low quality _ pellets and poor installations require more vtrtjm swt C11. frequent chimney cleanings. See Page 3 DAMPER SHAFT "Preventing Chimney Fires". The products \ of combustion will also contain small particles of fly ash. The fly ash will collect in the exhaust vent and restrict the flow of the f '- • +� _ flue gases. Determine the frequency of ; ~ } cleaning by checking the amount of ash that _ ;.•.h `� Rr accumulates in the elbows or tees of the ` exhaust system. Ask the dealer for suggested Hoorn FAN EXHAUST FA frequency of cleaning, equipment needed and procedures for cleaning. Check the exhaust system at least once Figure 10 every two months during the first heating 4. The motor/fan area behind the Firebox and season or whenever switching to a new under the Hopper should be vacuumed annually fuel,to determine how often this is needed. (See figure 10). NOTE: UNPLUG THE INSERT. Slide the Insert out of the Fireplace Yearly Maintenance and carefully clean or vacuum any sawdust, Many dealers offer a Service Contract that cobwebs and household dust. Carefully vacuum will cover needed Periodic and Yearly around the fan motors. Call your dealer for this maintenance. Contact your St. Croix dealer service. for assistance in maintaining your stove in 5. The Exhaust fan should be removed and top condition. cleaned annually. Figure 1.0 shows the Vacuum Yearly maintenance is designed to assure Switch removed for easier access to the Exhaust safe operation, prolong the life of the stove fan. Remove the Motor and Impellor from the and help preserve its aesthetic appeal. housing as shown (may require a new gasket) to clean that area of the exhaust system. Clean the 1. Spring Shutdown. After the last burn in Exhaust fan motor with compressed air. Be sure the spring, cool the stove. Remove all pellets to remove any heavy build-up on the impellor at from the hopper and the auger. Thoroughly this time. Call dealer for this service. Annual clean the burn grate, burn grate box, ash pan oiling of the motors is not needed. York Operations Manual Page 13 6. Remove the Room Fan on a Yearly basis SAFE OPERATION. (may require a new gasket) and clean the Squirrel Cage and motor with compressed air. The room fan has 2 oil ports and should 1. Disposal of Ashes. Ashes should be placed be oiled yearly. in a metal container with a tight fitting lid. The closed container of ashes should be placed on a 7. With the Room Fan removed you have non-combustible floor or on the ground, well easy access to the Versa Grate system. This away from all combustible materials, pending should also be lubricated on a yearly basis final disposal. If the ashes are disposed of burial with some High Temp Anti-Seize (can be in soil or otherwise locally dispersed, they purchased at a local car parts store). There should be retained in the container until all are several areas to lubricate (see figure 11 cinders have thoroughly cooled. below). They are: the Cam, Rear Bushing & Rod of the Shaft/Cage Weldment and the Front Bushing (for location of the front 2. Never use Gasoline, gasoline type lantern bushing see figure S on page 9, it is located fluid. Kerosene, charcoal lighter fluid or similar in the front of the stove, below the Grate liquids to start or "freshen up" a fire in this Weldment and Shaker Plate in the Firebox). heater. Keep all such liquids well away from the These are all moving parts and over time may heater while it is in use. start making a high-pitched "Squealing" sound. 3. Creosote, Soot and Fly Ash: Formation LUBRICATE and Need for Removal. The products of SHAFT/CAGE wELDMENT combustion will contain small particles of Fly Ash. The fly ash will collect in the venting system and restrict the flow of flue gases. LUBRICATE Incomplete combustion, such as occurs during CAM start-up and shut-down, or incorrect operation of the room heater will lead to some soot or mm® creosote formation which will collect in the ° ° venting system. The exhaust system should be inspected regularly during the heating season to determine if creosote buildup has occurred. LUBRICATE BUSHING Check more frequently at first to determine a &ROD schedule for cleaning the venting system based VERSA GRATE on individual use of this Pellet-burning heater. If MOTOR creosote has accumulated, it should be removed to reduce the risk of a chimney fire. Figure 11 8. Periodically inspect the condition of the 4. Do not over fire this unit. Follow all rope gasket around the door, window and ash instructions regarding the proper use of this door. Replace as needed. heater Fall Startup.Prior to lighting the first fire check the outside area around the exhaust and air intake systems for obstructions. Try all controls to see that they are working prior to lighting a York Operations Manual Page 14 TROUBLESHOOTING & FRQUENTLY ASKED QUESTIONS The stove is very trouble free in operation when properly maintained and quality pellets are used. When the stove fails to operate properly, troubleshooting by the operator of the stove is limited. Please read the following guide for answers to frequently asked questions 1. When first starting the stove remember the auger tube is empty, which will delay feeding fuel to the burn pot.This will in some cases prevent the stove from starting. Solution: Prime the burn pot if the auger tube is empty. 2. My stove isn't burning and the number 2 Feed Light is blinking. This diagnostic light indicates the vacuum switch no longer senses negative pressure in the firebox area of the stove. What caused the stove to go out? a. The door of the unit was left open longer than 60 seconds. (See solution) b. The ash pan door was left open for longer than 60 seconds. (See solution) C. The combustion fan is not running. (Defective fan or control board) d. The vacuum switch is defective. e. The vacuum hose is disconnected a. The vent system is plugged with fly ash. Solution: If the fire is out, re-light the stove. If the fire is still burning make sure all doors are securely latched and hold down the On/Off button (approximately 5 seconds) until stove starts up again. This will restart the stove in the start-up program. Occasionally use the auger button to manually feed fuel until the auto-feed takes over(Auto feed will start 5 minutes after the stove has been restarted). 3. My stove isn't burning and the number 3 Feed Light is blinking. This diagnostic light indicates that the Proof of Fire Switch no longer senses a fire in the stove. First check to see if there are pellets in the hopper. If there are pellets in the hopper, why did the stove go out? a. Unburned fuel in the Burn Pot means the fire went out before the Auger quit feeding. Solution: There is too much combustion air, adjust the air damper or the Draft Trim on Level 1. Pellets would still feed until the P.O.F. switch eventually shuts the stove down(See Damper Adjustment in the Operations Manual and point 8 on page 18). b. If the Burn Pot is empty means the Auger quit feeding fuel while there was still a fire in the bumpot. Check to see if there is fuel in the hopper. If the hopper is empty, fill the hopper and re-light the stove. C. If there is fuel in the hopper, check to see if there is an obstruction in the auger system or if the auger set screw is loose. Solution: Remove obstruction and re-light the stove or tighten the setscrew on the auger shaft. York Operations Manual Page 15 4. My stove isn't burning and the #2 and #3 Feed Lights are blinking simultaneously. These 2 LED lights diagnose the High Limit Switch and will indicate the stove reached an Over Temp situation. a. Check to see if the High Limit switch needs to be reset. If the High limit switch needs to be reset, do not use the stove until you find out why the High Limit tripped. b. The room air fan could be defective or the fan may need cleaning. c. The high limit switch also may be defective. It is best to call your dealer for support when trying to troubleshoot the High Limit Switch. Do not use your stove if the High Limit switch frequently trips. 5. I lit the stove and the # 2 Feed Light immediately started blinking and smoke spills out of the stove.How do I get the stove to quit smoking? Cause: The stove did not establish a vacuum and shut down. With the fuel in the pot burning, the smoke finds the path of least resistance and leaks out into the house. (See Installations Manual. Minimum vertical height needed to establish some natural draft and prevent smoke spillage) Solution: Pull the Slide-Out Bottom out and drop the fuel into the ash pan. This will minimize the amount of smoke that can spill into the room. 6. I turned the stove on with the On/Off switch and nothing happens. First check to see if the stove is plugged in and the receptacle has power to it. Solution: Check the fuse on the back of the control board. Replace with a 250 Volt, 5 Amp fuse.Part Number 80P20057-R 7. Why is my glass dirty? Normal operation of your St. Croix stove will produce a white/tan build-up on the glass that wipes off with a dry paper towel. However, extended burning on the low setting only,will produce a darker tan color.These types of build-up on the glass are normal. A heavy black build-up on the glass could indicate a problem. Solution: Adjust the combustion air setting to the proper setting. If this doesn't seem to help, make sure the clean out cover plates are installed in the stove. It also could be an indication that the stove is getting plugged and needs a good cleaning. Refer to the section in the manual that covers the Daily, Periodic and Yearly Maintenance of the stove. York Operations Manual Page 16 8. How do I adjust my low burn #1 setting)?Not all pellets burn at the same rate. The quality of the pellets and the BTU �iH content greatly influences the burn. Following is a � C description of the function of the auger trim button. The type of fuel used will determine the solution needed. Higher BTU fuel may require a reduction of the federate. Lower Y , BTU fuel may require an increase in the federate. / 4 : Solution: The auger trim button on the control board / allows the feed rate on #1 to be increased or decreased depending on the type of fuel used. a. Pressing the auger trim button once will turn ,f£ �.. r the #1 and #5 light on at the same time. This is an increase of .25 seconds to the On-Time =V of the#1 setting. ` IN r This is the#1-High setting, 1.75 secondsjy k "" F Using the auger trim button is also helpful when trying to keep the glass cleaner when burning on the #1 setting. The .; more fuel on low will usually mean less build up on the rv - glass. r � b. Pressing the auger trim button again will turn 9 on the #1 and #4 light at the same time. This y%' F, l will decrease the feed rate by .25 seconds. rn W r £ This is the#1-Low setting 1.25 seconds. f U wo The #1 Low setting will give less heat, but will also cause more build-up to form on the glass. ZZ, r York Operations Manual Page 17 9. Why is my glass dirty and how to use the Fan button to help w j, correct it?Normal operation of your St.Croix stove will produce a build-up on the glass that should be wiped off on a daily basis However certain types of pellets or extended burning on the low z rte" setting will cause the glass to smoke up faster. ��% r � A heavy black build-up on the glass could indicate a problem You will find two types of heavy build-up that should be looked into further. c ' a. A heavy black sooty build-up that wipes off £ easily with a dry paper towel. y Solution: This type of build up usually means not enough combustion air. First look at the condition of the / .` bumpot to determine that it doesn't need `g cleaning. If the pot is plugged the burning pellets will be lacking in combustion air and produce black soot. Clean the pot and only adjust . the damper after observing the burn. If you see black tips of smoke on the flame open the m damper in small increments (Read "Damper Adjustment" on page 8). After adjusting the damper wait 15 minutes for the pot to balance out ` °�'" before making another adjustment. b. A heavy shiny "glazed" build up on the glass usually means too much air when the stove is burning on the lower levels(levels 1 &2). When burning the stove like this the pellets "flame-out" every so often, when the auger feeds more pellets they tend to smolder too much causing this stubborn build-up on the glass. Solution: First trim the combustion fan voltage for level I by pressing the fan button once (see button in figure to the right indicated with the arrow). You will see all five lights on the light bar flash once. This will reduce the combustion fan voltage by approximately 5 volts. Stoves hooked to tall vertical chimneys may need another adjustment by pressing the fan button again. All five lights on the light bar will flash twice. This will reduce the voltage again. Pressing the fan button again or if the stove is unplugged will reset the voltage to the default setting. This will help compensate for the natural draft in the chimney. Secondly read the section in the Operations Manual on adjusting the damper. close the damper until the flame gets lazy with black tips on the flame. Now open the damper in small increments of 1/16t' of an inch or less. Wait 15 minutes after each adjustment to observe the burn. Once the flame becomes brisk without black tips you have the correct amount of air. Do not open the damper too far(Read "Preventing Chimney Fires on page 3 of this manual) Remember: Any of the above mentioned adjustments to the#1 setting using the Draft Trim or the Feed Trim on the control board will be lost if the unit gets unplugged or if there is a Power Failure. York Operations Manual Page 18 10. The ON/OFF light blinks under certain conditions.Does this mean anything? a. The ON/OFF light blinking will mean one of two things. When the stove is first started and the stove is in the r "Start-up" program, the light blinks until the "Proof of Fire" switch locks in. This indicates the "Normal s16"02 Operation"and the light stays on constantly. b. If the stove is running on a Thermostat, it will start up as described in point (a), but during "Normal Operation" a when the Thermostat is not calling for heat the stove drops to the #1 setting and "Pilots" until the thermostat a"`# calls for heat again. The LED light indicating the Heat Level will not drop to the #1 setting during "Pilot q Mode". During this time the ON/OFF light will be blinking and the auger light blinks when pellets are feeding into the bumpot, indicating that the stove is in 3�n "Pilot Mode". If the stove is running in "SmartStat" Mode, the stove will shut down completely 1 hour after the Thermostat called for heat the last time. Once the stove has completely shut down, all lights on the board are off with the exception of the On/Off light. It will be blinking. 11. The ON/OFF light is always blinking and the stove only runs on with a low fire, even though I have the Heat Level on#5. If the stove is operating on a Thermostat, this usually indicates a problem in the Thermostat circuit. There is either a bad connection in the wires or the Thermostat itself has a problem. Troubleshoot all of the components in the system. If the stove is not operating on a Thermostat,make sure the slide switch on the control board is in the"Manual"position. 12. I am running my stove on the SmartStat with a Thermostat and I can't shut the stove down. This may also be an indication of a problem in the thermostat circuit or of running the stove incorrectly. If the slide switch with #6 (See figure 2 on page 5) is set to "SmartStat" and the thermostat circuit is calling for heat, the stove cannot be shut off at the control board. You must first shut the thermostat off and then shut the stove off at the control board. If this isn't possible it may indicate a problem in the thermostat wires from the stove to the Thermostat or a defective Thermostat. These questions and answers will usually solve most problems that you run into during the break- in period of the stove or if a component fails in the stove. Before calling your dealer for assistance,please read your Operations Manual and perform all the maintenance issues covered in the Daily and Periodic Maintenance section of the Manual. If the stove still does not operate correctly call your Dealer for Assistance. York Operations Manual Page 19 York Parts Layout 19 17 16 2D 15 �14 ° 6 ® 21 b 13 22 0 0 1D 12 11 � - 7 9 6 4 1 # PART NUMBER DESCRIPTION 1 80P52893-R ASH LIP/DOOR 2 80P52897-R SIDE ASHPAN 3 80P52899-R CENTER ASHPAN 4 80P52897-R SIDE ASHPAN 5 80P52901-R LOWER TRIM PANEL 6 80P52263-R DECORATIVE GRILL-RIGHT 7 1 80P52263-R DECORATIVE GRILL-LEFT 8 80P52677-R IGNITER/HOT ROD 9 80P21279-R-LWCR BRICK PANEL—RIGHT SIDE 10 80P21279-B-LWCR BRICK PANEL-BACK 11 80P21279-L-LWCR BRICK PANEL—LEFT SIDE 12 80P53616-R LATCH BLOCK ASSEMBLY 13 80P52144-R RIGHT ASH LIP 14 80P52145-R LEFT ASH LIP 15 80P52146-R CENTER ASH LIP 16 80P52087-R HEAT EXCHANGE BAFFLE 17 80P53770-R HOT AIR BOX 18 80P20306-R SMALL BRASS COIL 19 80P52099-R TUBE SCRAPER ROD 20 80P53788-R DAMPER CONTROL PLATE ASSEMBLY 21 92N4114 DAMPER CONTROL KNOB 22 80P22348-R CONTROL BOARD York Operations Manual Page 20 Part Layout - Continued * 4 F r ti 54 of 2 0 ................................. ' x O � b� IrD O. a••• OPP t N ^3 .� ! 5 45 43 5� 44 Q 48 B 43' 46 iJ 38 .37 30 443 42 38 3119 44 33 34 # PART NUMBER DESCRIPTION 23 80P20296-R VERSA GRATE MOTOR 24 80P53402-R MOTOR MOUNT ASSEMBLY 25 80P53400-R SHAFT/CAGE WELDMENT 26 80P20340-R VERSA GRATE SPRING 27 80P50560-R CAM 28 80P20196-R CONVECTION FAN GASKET 29 80P20000-M CONVECTION FAN 30 80P50899-R MOTOR RETAINER BRACKET 31 80P52630-R TERMINAL BLOCK 32 80P20278-R AUGER MOTOR 33 80P20248-R 5/8"COLLAR W/SETSCREW 34 80P52957-R MOTOR MOUNT BRACKET 35 80P20245-R AUGER GASKET 36 80P50858-R AUGER BUSHING WASHER 37 80P53666-R AUGER WELDMENT 38 80P52887-R QUICK CONNECT PIPE ASSEMBLY 39 80P52232-R QUICK DISCONNECT GASKET 40 80P53667-R EXHAUST ADAPTER PLATE WELDMENT 41 80P20168-R COMBUSTION FAN GASKET 42 80P20038-R PROOF OF FIRE SWITCH 43 80P20001-R COMBUSTION FAN 44 80P52629-R MANUAL RESET HIGH LIMIT SWITCH 45 80P52628-R VACUUM SWITCH 46 80P50553-R SPACER 47 98360AI00 SSELF LOCKING TWIST PIN 48 80P52038-R SHAKER PLATE 49 80P52828-R GRATE WELDMENT 50 80P20026-R DOOR GASKET—5/8"ROPE 51 80P53724-R BLACK BAY DOOR FRAME 52 80P52796-R GLASS CLIP 53 80P20035-R BAY SIDE GLASS 54 80P20024-R 3/4"'WINDOW GASKET W/ADHESIVE 55 80P20027-R 5/8"WINDOW GASKET W/ADHESIVE 56 80P20024-R 3/4"'WINDOW GASKET W/ADHESIVE 57 80P20034-R CENTER DOOR GLASS 58 80P20035-R BAY SIDE GLASS 59 80P20131-R SMALL BRASS HANDLE COIL 60 80P53723-R HANDLE MOUNT PLATE 61 80P53773-R DOOR HANDLE 62 80P20183-R HANDLE PULL-HOPPER PARTS NOT SHOWN 63 80P20004-R POWER CORD 64 80P30074-R WIRING HARNESS-INSERT 65 80P65021-R HINGE PINS—MAIN DOOR 66 80P53787-R DAMPER CABLE ASSEMBLY CAUTION: The electrical components of the stove are not owner serviceable. Call your dealer for proper diagnosis of electrical problems and service to those components. York Operations Manual Page 22 ST. CROIX YORK INSERT WARRANTY The pellet insert manufactured by Even Temp, Inc. is warranted for five(5)years,to the original owner, against defects and workmanship on all steel parts (excluding the burn grate) and two (2) year on electrical components from the date of sale to the original owner. There specifically is no warranty on the paint,glass,burn grate, cera board and all gaskets. There is no written or implied performance warranty on the stove, as the manufacturer has no control over the installation, daily operations,maintenance or the type of fuel burned. This warranty will not apply if the stove has not been installed, operated and maintained in strict accordance with the manufacturer's instructions.Burning other than high quality wood pellets that meet A.P.F.I. specifications may cause stove damage and could void the warranty. The warranty does not cover damage or breakage due to misuse, improper handling or modifications. A warranty registration card is provided. The card is to be checked and signed and returned to factory,by the owner.Appropriate information is to be noted on the card. All claims under this warranty must be made through the dealer where the stove was purchased. If an inspection by the dealer indicates that a warranty claim is justified, and that all conditions of this warranty have been met, the manufacturer's total responsibilities and liabilities shall be to repair or replace, at the manufacturer's option, the defective part(s). All costs of removal, shipment to and from the dealer or manufacturer, any losses during shipment and reinstallation and any other losses due to the stove being removed shall be covered by the owner of the stove. NEITHER THE MANUFACTURER, NOR THE SUPPLIERS TO THE PURCHASER, ACCEPT RESPONSIBILITY, LEGAL OR OTHERWISE, FOR THE INCIDENTAL OR CONSEQUENTIAL DAMAGE TO PROPERTY OR PERSONS RESULTING FROM THE USE OF THIS PRODUCT. ANY WARRANTY IMPLIED BY LAW, INCLUDING BUT NOT LIMITED TO IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS, SHALL BE LIMITED TO ONE (1) YEAR FROM THE DATE OF ORIGINAL PURCHASE. WHEN A CLAIM IS MADE AGAINST THE MANUFACTURER BASED ON THE BREACH OF THIS WARRANTY OR ANY OTHER TYPE OF WARRANTY EXPRESSED OR IMPLIED BY LAW, MANUFACTURER SHALL IN NO EVENT BE LIABLE FOR ANY SPECIAL, INDIRECT, CONSEQUENTIAL OR OTHER DAMAGES OF ANY NATURE WHATSOEVER IN EXCESS OF THE ORIGINAL PURCHASE PRICE OF THIS PRODUCT. ALL WARRANTIES BY MANUFACTURER ARE SET FORTH HEREIN AND NO CLAIM SHALL BE MADE AGAINST MANUFACTURER ON ANY ORAL WARRANTY OR REPRESENTATION. Some states do not allow the exclusion or limitation of incidental or consequential damages, or limitations of implied warranties,therefore the limitations of exclusions set forth in this warranty may not apply to you. This warranty gives you specific legal rights, and you may have other rights,which vary from state to state. York Operations Manual Page 23 Notes: After the break in period, please note any adjustments that were made to the Feed Trim and Draft Trim on the control board in the area below. In the event of a power failure or if the units gets unplugged,the trim settings will be lost. Draft Trim: Circle one(See point 4 on page 4) Default Draft Low Draft High Draft Feed Trim: Circle one(See point 5 on page 5) Default Pilot High Pilot Low Pilot Serial Number: Date of Purchase: Dealer Information: Even Temp, Inc. P.O. Box 127 Waco, NE 68460 EMAIL: serviceLPeventempinc.com WEB ADDRESS:www.steroixhcat.coni York Operations Manual Page 24 } Date...........�7........... ... - NOR7M �? °oma TOWN OF NORTH ANDOVER PERMIT FOR WIRING ��SSACHUS� This certifies that ............ ....... .�.veE/4........................................... has permission to performs wiring in the building of.............. ¢1rn� c�.�.i .......:................. .. .......................... ........... at.........[Q��'.. .�`�....5�........................`...n.p,North Andover,Mass. Fee.2a. ..... Lic.No/O[Zx„�.......... ELECTRICAL INSPECTOe / Check # �7 88 /- 3 Official USB Only � ommoniva¢ 0 LLdd¢C flda�d c� Permit No, Z JaPar�matsl o�.�irc �arvica� occupancy and Fee Checked BOAev. (Rc PRBVBNTION R�GUt�,AT10NS [Rev. 1/07) (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(NEC),527 CNM 12:00 (PLEASE PRIN7-17\7 INT'OR TYPE ALL INFORMATION) Date: 6/9/09 North Andover To the Ins ector of Wires: Cite or Town of. P By this application the undersigned gives notice of his or her intention to perform the eiecu'ical work described'below, Location (Street d N bet 66 Lacy St Owner or Tenant ralg Telephone No. 978-836-7554 Owners Address 66 Lacy St,North Andover,MA 01845-3307 Is this permit in conjunc*& i§l��h hermit? Yes ❑ No ❑x (Cheek Appropriate Box) Purpose of Building Utility Authorization No. Eaisting Service Amps / Volts Overhead❑ Undgrd❑ No. of Meters New Service Amps / Volts Overhead❑ Uadgrd ❑ No.of Meters i Number of Feeders and Ampaelty t Location and Nei ture of Proposed Electrical Work: Completion of the followin table mm)be waived by the Inspector ol"Wirm, No. of 1 otal No.of Recessed Luminaires No.of CeiL-Susp. (Paddle)Fans Transformers KVA No,of Luminaire Outlets No.ofHot Tabs Generators KVA Above o. o ency i4ganag No.of Luminaires Swimming Pool d ❑ d. ❑ $attery units No.of Recentaele Outlets No.-of Oil Bnrners FIRE:�:MS No. of Zones No. of Detection and No.of Switches No.of'Gas Burnersqq Inkintinv Devices No.of Ranges No.of Air Cond. Tonal c� No. of Alerting Devices No.6f-Wake Disposers TOWS p Number ensRen In— an/Alerfing Devices No.of Dishwashers Space/Area Heatiag al b'W Local Chin natio ❑ Other Connection No. of Dryers Heating Appliances K�' ecurlty Systems:, No.of Devices or Eouivalent No. of W ater NL Of No,of Data Wiring: Heaters KW Siens BaIIasts No.of Devices or Louivalent a Bathtubs No.of Motors Total HP a No ofDeiceio r iria�; No. Hydromassage No.of Devices aEauivaelent OTHER: Attach additional detall if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Inspections to be requestod in accordance with MEC Rule 10,and upon completion. I NSUP.ANCE COVERAGE: Uniess waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its.substantial equivalent. The undersigned certifies that such covin ge is in force,and has exhibited proof o1LgKV eAWcFnit•issuing office, CI IECK ONE; INSURANCE ❑ BOND ❑ O=R ❑ (Specify:) T certify, under the p � t3 �r(br�g vi t# it Cmation on this applir�tion is true and complete 10128A 1-1 RM NAME: Richard F.Caver ,.? /7 2 LIC.NO.: Licensee: Signatur< G /' / LIC.NO.: (I/uppbcable, enter " �eCti»t c391h�et eq 7tit tqn,MA 018M I Bus.TeL Ne.- A d d ress: Alt.TeL No.- 1: o.:"'Per M.G.L. c. 147,s. 57-61,security wort:requires Department of Public Safety"S" License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)0 owner ❑owner's anent, 20. ��-nur/Agent PERMIT FEE: 9' 0 5ienai.nre Telephone No. ! IU-ip1.5111t ltl" 1-111 1"" VUI !lb�.��7f1dd- y.r LL AwAgab July 20, 2009 Inspector of Wires 1600 Osgood Street North Andover, MA 01845 Re: MGL Chapter 143 Section 3L notification Dear Inspector of Wires, Please be informed that the permitted installation wiring for Craig Robinson at 66 Lacy St,Nc Andover, (978) 836-7554 is complete and ready for inspection. Respectfully, Richard F. Cayer, MA Lic. #A10128 KeySpan Home Energy Services 62 Second Ave Burlington, MA 01803 (781) 359-2710 75U'17' Date. .IAA 0.b U... . Of AORTN TOWN OF NORTH ANDOVER H A 41 • PERMIT FOR GAS INSTALLATION SACMUSE� This certifies that . . . �. fv 14 ?�� .�. .� G `. . . . . has permission for gas installation . .1�. .. . . . . . .` .. . . . in the/buildings of . . . . �7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . at . .(r . . i�,.N.9 .t P.1�. . . .//, -�-.,.,Nort_h Andover, Mass. r Fee.,, . . . . Lic. No./!. ?�.`. . . . . . . . :_. . . V. i. . . GASINSPECTOR ' Check# / F NUSSACHGSETTS UNIUDEVI APPUCATON FOR PERIM TO DO GAS FITTING (Type or print) Date /1-94V/Ll Q NORTH ANDO ER,'MASSACHUSETTS Building Locations EiUj 06 "" Permit# (.� Lda / eo Af110Unt L em r e CUwner's Name New Renovation Replacement Plans Submitted El `3 En O zz F CG 9 a O U zW. Z F z F Ca W F OF a O GCW7 H Z H a W �' F -) Fli H F �+ V] z O r a0 U) �iO w A C7 �a U x CWS O SUB -BASEMENT BASEMENT 1ST. FLOOR 2ND . FLOOR 3RD. FLOOR . 4T II . FLOOR 5TH . FLOOR 6TH. FLOOR 7TH. FLOOR , 8TH . FL0OR (Print or type) e one: Certificate Installing Company ;`lame r'7 „ Corp. /1-112 Address 3 �� �� f❑�Partner.. Business Te ephone ` Firm/Co.- Name irm/Co:Name of Licensed Plumber or Gas Fitter Lei 1SURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes M No If you have checked M,please' dicate the type coverage by checking the appropriate.box. Liability insurance policy Other type of indemnity Bond Owner's Insurance Waiver: I am aware that the licensee does not have the:Insurance coverage required by Chapter 112 of the o Mass. General Laws;and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner 0 Agent I hereby certify that all of the details and information I have Submitted(or entered)in above application are true and accurate to the, I.;cSt of my knowledge and that all plumbing work and installations performed under Permit ISSUed For this application will be in compliance with all pertinent provisions of the MassuchL CUS,tat°G, �;u d Ch', ter 142 of the General Laws. 13 v: Signature of Licensed Phunnber Or Gas Fitter Title Plumbcr �Q 0" CityiTown0 Gas Fitter Clcense i um er Master , :APPROVED(GFFICE USE ONLY) Journeyman INSTALLATION INSTRUCTIONS AND �® Heafing Systems OWNER'S MANUAL UNVENTED _ ROOM HEATER MODELS BF-10-2 BF-20-2 BF-30-2 pESIG�y SP . �� CERiiF1Ep Installer: Leave this manual with the appli- This appliance may be installed in an after- ance. market, permanently located, manufactured Consumer:Retain this manual for future refer- (mobile) home, where not prohibited by local ence. codes. This appliance is only for use with the type of WARNING:If the information in these instruc- gas indicated on the rating plate.This appliance tions are not followed exactly,a fire or explosion is not convertible for use with other gases. may result causing property.damage, personal injury or loss of life. This is an unvented gas-fired heater.It uses air (oxygen)from the room in which it is installed. — Do not store or use gasoline or other 8amma- Provisions for adequate combustion and venti- ble vapors and liquids in the vicinity of this or lation air must be provided. Refer to page fi. any other appliance. WHAT TO DO IF SIT aFI.L C i NNIAWNING: If not installed, operated, °a:«l Do not try to light any appliance.Imaintained in accordance with the nianufactur- • Do not touch any electrical switch; do not er s instructions,this product could expose you use any phone in your building. to substances in`fuel or from fuel combustion lii$iieddateir' cat .yoni was ss �+ ''. which can cause death or serious illness. • er from. a iI neighbor's phere. Fof oiv the gas. sup- � . j 'o-81ATER VAPOR: A BY-PRODUCT OT e 's instructions. i FHEATERS�-UNVENTED ROOM you c a n nat re� .l, yCal' 4-,;a s 'a ro:, IZ� f�c, �J �a P� l� � Jt;(t G'S + . ike, fare tiel,t� =. 3�xi�. r� ;. � •axiti�:n`4.d r�t3m�2':'�.�t€'r��i oe�idir��. '�_�;�'<.� ���"i_.�.�',��� � Instaliation and servicd must I3�"j)c�ivF' et�u l�trn j + (Di1C (1) C/Rince (�(ii7il) 3�i rti��te& Erb€' ;i e ry I Wit) —. 1 qu2!:f ed $nstafl;er se.-i r sa:c `Z ell.'� .n.. i:46: i• *�1€$ `E `"s'. .t 1.P I or - ' :7 �• ' �- q.�F+Y yy C. ��S €f`sf �.$ supplier. -- page 6. ' ; TABLE OF CONTENTS SECTION PAGE ImportantSafety Information ......................................................................................................................3 Safety Information for Users of LP Gas ....................................•--••---..........-----------.---..........---.......---..........4 Introduction..................................................................................................................................................5 Specifications...............................................................................................................................................5 Water Vapor:A By-Product of Unvented Room Heaters.............................................................................6 Provisions for Adequate Combustion and Ventilation Air...........................................................................6 GasSupply...................................................................................................................................................7 Clearances ...................................................................................................................................................8 Optional Floor Stand Installation......................................................................... WallMount Installation ...............................................................................................................................9 LightingInstructions .........................•----...............................................................----................................10 Main Burner Flame Characteristics ..........................................................................................................11 PilotFlame Characteristics .....................................................................................................................:.12 ThermostatOperation..........................................•--•-•--........---...........-.----.........................---..............:.......12 ApplianceMaintenance .............................................................................................................................13 Troubleshooting............................................................................................... .....14 ..................................... Howto Order Repair Parts.........................................................................................................................14 PartsList ...................................................................................................................................................15 PartsView..................................................................................................................................................16 Optional Blower Installation Instructions ........................... .........17-18 Service Notes................................. ....................................:............: .............................. 19 Pace 2 16913-7-0907 S is t5 -k cn ?2w .F y THIS IS A HEATING RIPLIC NC;E DO NOT OPERATI=,T HIS APPLI ANCF WITHOUT FRONT PANEL INSTALLI~,D. An uave.nted room izeater having an input ratin-g of SERVICE ADERSON. The appliance should be inspected inere than 6,000 Btu per hfjur shall not l,e in a 'before use and at least annually by a profcssion-al service bathroom. person. More frequent cleaning maybe required due to • An unvented room heater having an input rating of more excessive lint from carpeting, bedding materials, etc. It than 10,000 Btu per hour shall not be installed in abedroom is imperative that control compartments, burners and or bathroom. circulating air passageways of the appliance be kept clean.. • Due to high temperatures,the appliance should be located out of traffic and away from furniture and draperies. DO NOT use this room heater if any part has been under water. Immediately call a.qualified service technician • Children and adults should be alerted to the hazard of to inspect the room heater and to replace any part of the high surface temperature and should stay away to avoid control system and any gas control which has been under burns or clothing ignition. water. • Young children should be carefully supervised when they . Keep appliance area clear and free from combustible are in the same room with the appliance. materials, gasoline and other flammable vapors and • Do not place clothing or other flammable material on or liquids. near the appliance. . WARNING:ANY CHANGE TO THIS HEATER OR ITS . Due to high surface temperatures,keep children,clothing CONTROLS CAN BE DANGEROUS. and furniture away. Any safety screen or guard removed for servicing an • WARNING: Do not use a blower insert, heat exchanger appliance must be replaced prior to operating the heater. insert or other accessory not approved for use with heater. WARNING: Failure to keep the primary air opening(s) of the burner(s)clean may result in sooting and property • Installation and repair should be done by a QUALIFIED damage. WARNING When used without adequate combustion and ventilation air, CARBON MONOXIDE POISONING MAY LEAD TO heater may give off CARBON MONOXIDE, an odorless, poi- DEATH. sonous gas. Early signs of carbon monoxide poisoning resemble the flu,with Do not install heater until all necessary provisions are made for headache,dizziness and/or nausea. If you have these signs,heater combustion and ventilation air.Consult the written instructions may not be working properly. Get fresh air at once! Have heater provided with the heater for information concerning combus- serviced. tion and ventilation air. In the absence of instructions,refer Some people—pregnant women,persons with heart or lung dis- to the National Fuel Gas Code,ANSI Z223.1/NFPA 54,Air ease,anemia,those under the influence of alcohol,those at high for Combustion and Ventilation,or applicable local codes. altitudes—are more affected by carbon monoxide than others. This heater is equipped with a PILOT LIGHT SAFETY SYS- The pilot light safety system senses the depletion of oxygen at TEM designed to turn off the heater if not enough fresh air is its location. If this heater is installed in a structure having a high available. vertical dimension,the possibility exists that the oxygen supply at the higher levels will be less than that at the heater. In this type DO NOT TAMPER WITH PILOT LIGHT SAFETY of application, a fan to circulate the structure air will minimize SYSTEM! this effect. The use of this fan will also improve the comfort level If heater shuts off,do not relight until you provide fresh air.: in the structure. When a fan is used to circulate air,it should be located so that the air flow is not directed at the burner. If heater keeps shutting off, have it serviced. Keep burner and control compartment clean: 16943-7-0907 Page 3 Hill,11111 SAFETY INFORMATION FOR USERS OF LP-GAS Propane(LP-Gas)is a flammable gas which can cause fires by point with the members of your household. Someday and explosions. In its natural state,propane is odorless and when there may not be a minute to lose, everyone's safety colorless.You may not know all the following safety precau- will depend on knowing exactly what to do. If, after read- tions which can protect both you and your family from an ing the following information,you feel you still need more accident. Read them carefully now,then review them point information,please contact your gas supplier. LP-GAS WARNING ODOR If a gas leak happens,you should be able to smell the gas because of the odorant put in the LP-Gas. That's your signal to go into immediate action! • Do not operate electric switches, light matches, use your Use yourneighbor's phone and call a trained LP-Gas service phone.Do not do anything that could ignite the gas. person and the fire department. Even though you may not • Get everyone out of the building, vehicle, trailer, or area. continue to smell gas,do not turn on the gas again. Do not Do that IMMEDIATELY. re-enter the building,vehicle,trailer,or area. • Close all gas tank or cylinder supply valves. Finally,lettheservice man and firefighters check for escaped • LP-Gas is heavier than air and may settle in low areas such gas.Have them air out the area before you return.Properly • as basements.When you have reason to suspect a gas leak, trained LP-Gas service people should repair the leak,then keep out of basements and other low areas. Stay out until check and relight the gas appliance for you. firefighters declare them to be safe. NO ODOR DETECTED - ODOR FADE Some people cannot smell well. Some people cannot smell the in LP-Gas also are subject to oxidation.This fading can occur if odor of the chemical put into the gas. You must find out if you there is rust inside the storage tank or in iron gas pipes. can smell the odorant in propane. Smoking can decrease your The odorant in escaped gas can adsorb or absorb onto or into walls, ability to smell.Being around an odor for a time can affect your masonry and other materials and fabrics in a room.That will take sensitivity or ability to detect that odor. Sometimes other odors some of the odorant out of the gas,reducing its odor intensity. in the area mask the gas odor.People may not smell the gas odor or their minds are on something else.Thinking about smelling a LP-Gas may stratify in a closed area,and the odor intensity could gas odor can make it easier to smell. vary at different levels. Since it is heavier than air,there may be The odorant in LP-gas is colorless, and it can fade under some more odor at lower levels.Always be sensitive to the slightest gas odor.If you detect any odor,treat it as a serious leak.Immediately circumstances. For example,if there is an underground leak,the movement of the gas through soil can filter the odorant.Odorants go into action as instructed earlier. SOME POINTS TO REMEMBER • Learn to recognize the odor of LP-gas.Your local LP-Gas to set too long before refilling. Cylinders and tanks which Dealer can give you a"Scratch and Sniff'pamphlet.Use it have been out of service for a time may develop internal rust to find out what the propane odor smells like.If you suspect which will cause odor fade.If such conditions are suspected that your LP-Gas has a weak or abnormalodor, call your to exist, a periodic sniff test of the gas_is advisable. If you LP-Gas Dealer. have any question about the gas odor,call your LP-gas dealer. • If you are not qualified, do not light pilot lights, perform A periodic snit test of the LP-gas is a good safety rheasure service,or make adjustments to appliances on the LP-Gas under any condition. system. If you are qualified, consciously think about the If, at any time, you do not smell the LP-Gas odorant and odor,of LP-Gas prior to and while lighting pilot lights or you think you should, assume you have a.leak. Then take performing service or making adjustments. the same immediate action recommended above for the ac- I • So Mulles a basement or a cion d U? house has a l,(:sty casion when you do detect the odorized LP-Gas. 7 It ilhat Can cover 1p the L? C i Jti.?'. t7. it r ( )1i' 1,1It yoll CxpCriCI7C 2 Coilll)lete' at G)l t,"(the CJI7?til:7Cf 1S fill- . . . h 111ni 3!f alp lC I(�lll)�s,;11 ?I it It i i is ' ,n c I dr d de i t) Vapor ti'cSsnrC) Ctl]'1)the tank\<.lve Off 1117II1C l Ji l,y._� -- .. •,�'� e Luc Cin r't on,;.arc sur—Al—, t 1' - 1S JCf` on, teiC Cor)tafllCr 111`Y.1r - -7 a . . ( it Tf ti1C 7 fi 15 been a_IC'1 04 ,,,.,1' ),1) ni11o,S.S 'Ch,,S pilot li ht oljfifl....:.`j it occurs.some m l<. -. $ � ;-,tcriial xtv 'C,..t loCur.I+the i1 c in Wails OnGthl ✓V i ,Stt( is Icy t fL to .1. "a tt?f'Coiltd U1 lttt. Cylri?dCrS '111 18I7,.S, rS pG5�2ti1C. Iit(l lure, peop1C should be particularly alert and careful when new tanks or sure your container is under vapor pressure by turning it off 'C�l1aittn"5 rrl:^i?:;C(7 lie J. l t- L i) 1 QC(,, O+:C^.l ni I?%1V at the;Container it!boos comp!e e!y empty or . rt rCallt7d br iOrc it iscompletely cmpt) t 1!)1 S,or 1—c-nst:ll d'illi it h4,a.�.th a ` � e F .<Jfi!af1oW d . war 101 ci S d a C6 tat Instructions to Installer Qualified Installing Agency �I 1. InstaIlerinust ICave insirttctiOn mama;V.1ith instzl- Installation and renlaccrnent of gas piping, gas utilization equip-ment or accessories and repair and servicing of equipment shall 2. Installer must have owner fill cut and mail warraimty card sup- be per{orrned only by a qualifi":d agency. fhe tern "qualified nLcd with unvented room heater. agency":nca,s auy individual.furl,coTj,oratirin,or company that 3. Installer should show owner ho',v to skirt and operate unvented either ill person or a ret-esentative is cl;_>agcd in and is room heater-. re-ponsiblc` fol-(,;!} flY itis-:'!11Mi( 1 testing,or replac e.nient of_?as Always consult your local Building Department regarding regu- piping or(b)the coni' n :ectio ,nmstti{iation, testing,repair,or servic- ing ofequipinen(;:that is experienced in such work;that is familiar latious,codes or ordinances which apply to the i7lstaIlatioli of an with ail precatitions required, and that has complied with all the unvented room heater. requirements of the authority having jurisdiction. This appliance may be installed in an aftermarket* permanently State of Massachusetts: The installation must be made by a located, manufactured'(mobile) home, where not prohibited by licensed plumber or gas fitter in the Commonwealth of Mas- state or local codes. sachuse'tts. * Sellers of unvented propane or natural gas-fired supplemental Aftermarket:Completion of sale,.not for purpose.of resale,.from room heaters shall provide to each purchaser a copy of 527 the manufacturer. CMR 30 upon sale of the unit. This appliance is only for use with the type of gas indicated on the In the State of Massachusetts, unvented propane and natural rating plate. This appliance is not convertible for use with other gas-fired space heaters shall be prohibited in bedrooms and gases. bathrooms. The installation must conform with local codes or, in the absence General Information of local codes, with the National Fuel Gas Code,ANSI Z223.1/ This BF-10,BF-20 and BF-30 are design certified in accordance with NFPA54.* American National Standards Institute Z21.11.2 by the Canadian *Available from the American National Standards Institute,Inc., i I west 42nd • Standards Association as an Unvented Room Heater and should St.,New York,N.Y. 10036. be installed according to these instructions. High Altitudes Any alteration of the original design,installed other than as shown For altitudes/elevations above 2,000 feet(61 Om),ratings should be in these instructions or use with a type of gas not shown on the reduced at the rate of 4 percent for each 1,000(305m)feet above rating plate is the responsibility of the person and company mak- sea level. Contact the manufacturer or your gas company before ing the change. changing spud/orifice size. WARNING. This appliance is equipped for (natural gas or Well Head Gas Installations Some natural gas utilities use "well head" gas. This may affect propane)gas.Field conversion is not permitted. the Btu output of the unit. Contact the gas company for the heat- Important ing value. Contact the manufacturer or your gas company before All correspondence should refer to complete Model Number,Serial changing spud/orifice size. Number and type of gas. SPECIFICATIONS Model BF-10 BF-20 BF-30 Input Btu/HR(KW/H)(LP) 10,000(2.9) 20,000(5.8) 30,000(8.8) Input Btu/HR(KW/H)(NAT) 10,000(2.9) 18,000(5.3) 30,000(8.8) Height 22"(559mm) 22"(559mm) 22.'(559mm) Width 18"(457mm) 18"(457mm) 24 1/8"(536mm) Depth 6 1/2"(165mm) 6 1/2"(165mm) 6 1/2"(165mm) Gas Inlet 3/8"(10mm) 3/8"(IOmm) 3/8"(10mm) Accessories Blower SRB-18T SRB-18T SRB-30T Floor Stand SRS48* SRS-18 SRS-320 *SRS-1.9 floor stand can not be used in a bedroom installation- BF-10 must be wall mounted in a bedrobin installation. The bedroom must bean unconfined space. ANSl Z223.1/NF-PA 54 defines an unconfined space as "a space wlmose volume isnot less. than 50 cubic feet per 1,000 Btuper hour 4.8m3 per kw of the a� .e ate input radii of.alba trances installed in that space." p P ( P ) bg- g' P g: PP 1694'-7,-0907 - Page 5 . . Eel"I 'LJ D10 101 oil W , U 1 , 1 11ya 111151" Water vapor is a by-product of gas combustion.An unvented room The following steps will help insure that water vapor does not heater produces approximately one(1)ounce(30ml)of water for become a problem. every 1,000 Btu(.3KW's)of gas input per hour. 1. Be sure the heater is sized properly forthe application,including ample combustion air and circulation air. Unvented room heaters must be used as supplemental heat (a 2 If high humidity is experienced,a dehumidifier may used to room)rather than a primary heat source(an entire house).Inmost help lower the water vapor content of the air. supplemental heat applications,the water vapor does not create a 3 Do not use an unvented room heater as the primary heat source problem. In most applications,the water vapor enhances the low (an entire house). humidity atmosphere experienced during cold weather. PROVISIONS FOR ADEQUATE COMBUSTION & VENTILATION AIR This heater shall not be installed in a confined space or unusually Warning: If the area in which the heater may be operated is smaller tight construction unless provisions are provided for adequate than that defined as an unconfined space or if the building is of combustion and ventilation air. unusually tight construction, provide adequate combustion and The National Fuel Gas Code,ANSI Z223.1 defines a confined space ventilation air by one of the methods described in the National as a space whose volume is less than 50 cubic feet per 1,000 Btu per Fuel Gas Code,ANSI Z223.1/NFPA 54,Air for Combustion and hour(4.8m'per kw)of the aggregate input rating of all appliances Ventilation,or applicable local codes. installed in that space and an unconfined space as a space whose Unusually Tight Construction volume is not less than 50 cubic feet per 1,000 Btu per hour(4.8m' The air that leaks around doors and windows may provide enough per kw)of the aggregate input rating of all appliances installed in fresh air for combustion and ventilation. However, in buildings that space. Rooms communicating directly with the space in which of unusually tight construction,you must provide additional fresh the appliances are installed,through openings not furnished with air. doors,are considered.apart of the unconfined space. Unusually tight construction is defined as construction where: The following example is for determining the volume of a typical a. Walls and ceilings exposed to the outside atmosphere have a continuous water vapor retarder with a rating of one perm area in which the BF-20 may be located and for determining if this or less with openings gasketed or sealed,and area fits the definition of an unconfined space. b. Weatherstripping has been added on openable windows and The input of the BF-20 is 20,000 Btu per hour. Based on the 50 doors,and cubic feet per 1,000 Btu per hour formula,the minimum area that c. Caulking or sealants are applied to areas such as joints is an unconfined space for installation of the BF-20 is 1,000 cubic around window and door frames,between sole plates and feet,50 cubic feet x 20= 1,000 cubic feet.To determine the cubic floors,between wall-ceiling joints,between wall panels,at feet of the area in which the BF-20 is to be installed,measure the penetrations for plumbing,electrical,and gas lines,and at length,width and height of the area. Example: The area measures other openings. iC� feet in ien iii, 8 feet in :vid',it and S feet In height, the area.is ,;, i r itstalledinabuildingofunusuallyti,-lttcc�nstructioii, 1.024 cubic feet. The BF-20 can be installed in this unconfined a �` r for combustion,ventilation and dilution of flue gases spa..;•,with no requireincnt to r, oxide additional cotnbu�' i .a'd sh tlt, c ptovi�'�d in accordance with ANSI Z223.liNFPA54. ventilation air. The gas lint)can be routed ether through li C{lOU!' Of"�.Vitll.. L he vs .by the'National.Fuel Gjas (_.ode ibat adI 1p Bile be ;nsl illcd,near line opening should be made at this time. Location of the opening the gas inlet. This should consist of a vertical length of pipe tee will be determined by the position of floor joists and the valve and connected into the gas line that is capped on the bottom in which ulilon used r4:'scr ficin'? con'densa tion a:;d !'ol-'Ss_° l Ci� n pTticics may; coc 1 Gas Suppler Check all local codes for requirements,especially ibr the size and type 0f,=as supply line required. _ Recommended uas Pipe_13,im tc - - 1 . Pipe Length Schedule 40 Pipe + rubinwl 1}1 / Inside Diameter Outside D...n_.ler Nat. L.P. Nat. L.P. GAS SUPPLY - — - INLET 0-10 feet 1/2" 3/8" 1/2" 3/8" —r 0-3 meters 12.7mm 9.5mm 12.7mm 9.5mm ;/8 td. i.P- PC' Ns• `7U ) LUG,EOLE Mi1dIMUl1 i 0-40 feet U2' 1 2" 5!8' :OR TEST ,ACE + . 1 l.'2". 4A2 meters 12:7mm 12.7mm 15.9mm 12.7mm Figure 2 40-100 feet. 1.!2" /2" 3/4" I!=" Method of lnstalhn�a Tee Fitting Sediment Trap(Figure 2) 13-30 meters 12.7mm 12.7mm 19mm 12.7mm <. (Fig �' The use of the following gas connectors is recommended: 100-150 feet 3/4" 1/2" 7/8" 3/4" — ANS Z21.24 Appliance Connectors of Corrugated Metal Tub- 3146 meters 19mm 12.7mm I 22.2mm 19mm ing and Fittings Note:Never use plastic pipe.Check to confirm whether your local ANS Z21.45 Assembled Flexible Appliance Connectors of Other Than Al]-Metal Construction codes allow copper tubing or galvanized. `.T The above connectors may be used if acceptable by the authority Note: Since some municipalities have additional local codes,it is .having jurisdiction.The state of Massachusetts requires that a flex- ible appliance connector cannot exceed three feet in length. 3 9/16" GAS INLET IN BOTTOM (90mm) OF HEATER Pressure Testing of the Gas Supply System 1. To check the inlet pressure to the gas valve,a 1/8"(3mm)N.P.T. plugged tapping,accessible for test gauge connection,must be placed immediately upstream of the gas supply connection to the appliance. 1 1 TO WALL(43mn) L 2. The appliance and its appliance main gas valve must be discon- �.j nected from the gas supply piping system during any pressure testing of that system at test pressures in excess of 1/2 psig(3.5 VIEW FROM TOP OF HEATER kPa). 3. The appliance must be isolated from the gas supply piping sys- Figure 1 tem by closing its equipment shutoff valve during any pressure Installing a New Main Gas Cock. testing of the gas supply piping system at test pressures equal Each appliance should have its own manual gas cock. to or less than 1/2 psig(3.5 kPa). A manual main gas cock should be located in the vicinity of the Attention? If one of the above procedures results in pressures in unit. Where none exists, or where its size or location is not ad- excess of 1/2 psig(14"w.c.)(3.5 kPa)on the appliance gas valve, equate, contact your local authorized installer for installation or it will result in a hazardous condition. relocation. Checking Manifold Pressure Compounds used on threaded joints of gas piping shall be resistant Natural gas will have a manifold pressure of approximately 3.5" to the action of liquefied petroleum gases: The gas lines must be w:c.(.87kPa)-at the pressure regulator outlet with the inlet pressure checked for leaks by the installer. This should be done with a soap to the pressure regulator from a minimum of 5.0"w.c.(1.245kPa) solution watching for bubbles on all exposed connections, and if for the purpose of input adjustment to a maximum of 10.5" w.c. unexposed,a pressure test should be made. (2.615kPa). Propane/LP gas will have a manifold pressure ap- proximately 10.0" w.c. (2.49kPa) at the pressure regulator outlet Never use an exposed flame to check for leaks.Appliance must with the inlet pressure to the pressure regulator from a minimum be disconnected from piping at inlet of control valve and pipe of 11.0" w.c. (2.739kPa) for the purpose of input adjustment to a capped or plugged for pressure test. Never pressure test with maximum.of 13.0"w.c.(3237kPa): appliance connected; control valve will sustain damal;c? A test gage connection is s located.dowtjstream of the gaa pliance A gas valve and ground joint union should be installed in the gas b p pressure regulator for measuring gas pressure:. The connection is lime.upstireanrof the gas control to aid in servicing. L is.requires;. a 1/8 inch(3mm)N.P.T.plugged tapping: 16943-7-0907 Page 7. CLEARANCES When facing the front of the appliance the following minimum clearances to combustible construction must be maintained. Do not install in alcove or closet. BF-10/1317-20 - BF-30 Left side 5"(127mm) 8"(203mm) Right side 5"(127mm) 8"(203mm) Rear wall 0"(Omm) 0"(Oram) Ceiling 36"(914mm) 36"(914mm) Minimum vertical clearance from a projections above 36"(914mm) 36"(914mn2) the appliance(shelves,window sills,etc.) Floor(top surface of carpeting,tile,etc.) 2"(51 mm) 2"(51 mm) Provide adequate clearances around air openings. Adequate accessibility clearances for purposes of servicing and proper operation must be provided. CEILING CEILING SIDE WALL SIDE WALL 36' (914mmi MIN. 36 MIN v[(J M;;,—{ 8 MIN. 8 MIN. I27nm � � � i27T,m V; j WE. ®®®®® -- ®E=EH=E=® L I,' iii ---� 2MIN FLOOR BF-10 and BF-20 BF-30 Figure 3 Figure 4 OPTIONAL • ND INSTALLATIO SRS-18* and SRS-30 Floor Stand Installation 1. Align clearance holes on floor stand with screw holes on o bottom of heater,as shown in Figure 5. 8 Attach floor sand , Ii] (i 1 SC,[ lVc.provided +.'lih � floor stand. I I M 3: Connect tilc.gas line.- * SRS-18 floor stand can not be used in a bedroom installation. BF-10 must be wall mounted in a bedroom installation. h r—� Installation on Runs:2nd Tile If this appliance Rance Is installed directly on carpetins; tuc, or other j s .,,r-'�5:.115,...iat t•._ . , ' 7 a:m;ta�G, \ a,;pane! the !itl inr �J C i t t•t?2 }''.Cor rt:32'.t z�LCS base refcrred to in .i scc..cn does nol cncan the fire-proof "- base as used on wood stoves. The protection is for rugs that are g 1 C;1t!::iilc:}y' ulick i, - . '1 P. - .. r.. - ..,(. i: iii�.i;it3r:.L_ 1'in.ti'C. Pa e 8 16143-7-090 D�,:�i T-siY .•�• S - ��' Yr a.=.�F �E!"�' fi a�.•a, ''� � �`,�,;s t �.+,+ a-s ,yn .i ��1 ......,__........- awe -„ Pcfcr to Figures(i and 7 for mrlsuromcl?ts in orde.,to locate (4)nu;untinv holes on ill- I ; ;tares r and 7 are ne lronl v i•ws of the heater. I. i c'mo-e lower louver from casin r!sseij-,! (2 :;ercv4s). �. 3—hove reflector from casing ass:nibly(2 screws). - 5. l emove upper:ouve.i ti'Ct[:i casingasSo?71bi�'(2 Se.l-eV1's). pili Selai W111 t.I-Cl' localln`ni liming hoicsaflach X i", ��SIt1111)SCI-c;Li•:;pro\iel into die \%, 1. I U aOt c0.l1plct0ly tl`.?hlen screwhCads I,,)the wall,leave a 1%8"(3n1 n)`ap arld wall. ._ ''•'blunt heater onto the 14)sc?-ewfleads and complete tlghtciing screwheads inn ih: Attention! Use the following steps to properly align the upper louver and the reflector with the heat shield. a. When replacing upper louver,be sure the bottom lip of upper louver goes behind the heat shield. b. When replacing reflector,be sure the top lip of reflector goes in front of the heat shield. 3. Connect the gas line. —24 1/8 (61 � 3mm)— --� �.2" — : 14"(356mm)— - ' -- — I2 ,, /8"(511mm) 2- m -- 13/32" 1 3/32" (28m m) I I I (28mm) IM ---- --- s-------------� 'T— OUTLINE OF I I OUTLINE OF OUTER CASING I OUTER CASING 18 7/8" i 18 7/8" (479mm) 22" (479mm) I 22" (559mm) I (559mm) ---- 4-- 4 1/32" l w 2 1/32"(52mm) 4 1/32" 4'2 1/32"(52mm) (102mm)MIN. �- FLOOR 2"(51mm)MIN. (102mm)MIN. _� 2"(51mm)MIN. 1 FLOOR MOUNTING HOLE LOCATIONS MOUNTING HOLE LOCATIONS VIEWED FROM FRONT OF HEATER VIEWED FROM FRONT OF HEATER BF-30 BF-10 and BF-20 Figure 7 Figure 6 On Sheet Rock Wall --- a 1. After locating mounting holes,drill(4)5/16"(8mm)diameter a STEP holes into the wall. 2.. Insert(4)plastic expansion anchors provided into the holes. 3. 'Tighten(4)#10x 1"(25mm)screws provided into the plastic o expansion anchors. Do not completely tighten screwheads to STEP 2 the plastic expansion anchors,leaved f/8"(3nun)gap between screwheads and plastic expansion anchors. o 4. Mount heater onto the(4)screwheads and complete tightening the screwheads to the plastic expansion anchors. p Attention! Use the following steps to properly align the upper louver and the reflector with the heat shield. a. When replacing upper louver, be sure the bottom lip of upper louver gock behind"the heat shield. STEP 3 b Whcn replacing tc+,cctor, be sure the top lip of reflector goes In front of the heai shield. 5. Connect the gas line iD Figure 8 16943-7-0907 Page 9. LIGHTING INSTRUCTIONS FOR YOUR SAFETY READ BEFORE LIGHTING WARNING: If you do riot follow these instructions exactla y, fire or explosion may result caus- ing property damage, personal injury or loss of life. A. This appliance has a pilot which must be lighted by hand. C. Use only your Wand to push in or turn the gas control knob. When lighting the pilot, follow these instructions exactly. Never use tools. If the knob will not push in or turn by hand, B. BEFORE LIGHTING smell all around the appliance area don't try to repair it;call a qualified service technician. Force for gas. Be sure to smell next to the floor because some gas or attempted repair may result in a fire or explosion. is heavier than air and will settle on the floor. D. Do not use this appliance if any part has been under water. WHAT TO DO IF YOU SMELL GAS Immediately call a qualified service technician to inspect the • Do not try to light any appliance. appliance and to replace any part of the control system and • Do not touch any electrical switch; any gas control which has been under water. do not use any phone in your building. • Immediately call your gas supplier from a neighbor's phone. Follow the gas supplier's instructions. • Ifyou cannot reach your gas supplier,call the fire depart- ment. LIGHTING INSTRUCTIONS I. STOP! Read the safety information above. 2. Set thermostat(gas control knob)to lowest setting. lit: If it goes out,repeat steps 4 through 8. If knob does not pop up when released, stop and im- 3. Turn off all electric power to the appliance(if applicable). mediately call your service technician or gas supplier. 4. Push in gas control knob slightly and turn clockwise If the pilot will not stay lit after several tries,turn the gas to "OFF". Do not force. control knob to"OFF"and call your service technician 3 4 or gas supplier. hJ/ S / CONTROL KNOB INDICATOR 9. Attention! Gas control has an INTERLOCK latching ob GAS CONTROL KNOB When.the pilot is initially lit and the sa SHOWN IN°OFF'POSITION fety magsener- gized net (pilot stays "ON") the INTERLOCK latching device becomes operative. If the gas control is turned to the"OFF" 5. Wait ten(10)minutes to clear out any gas. Then smell for Position or gas flow to the appliance is shut off, the pilot gas,including near the floor. If you smell gas,STOP!Follow cannot be relighted until the safety magnet is de-energized "B"in the safety information above. If you don't smell gas, (approximately 60 seconds). There will be an audible"click" go to the next step. when the safety magnet in the gas control is de-energized. THERMOCOUPLE Pilot can now be relighted. Repeat steps 4 through 8. 6. find pt!ot-tpc;).1Ci i;;attached at tilt ,EL C?Rv^DE 10. Turn 'r S vU1Tt JI 1, ono counterclock.�ise bo-, of the burner asses Liv. /. fLi gra l:(. .(?; !v)t;t.:c•t,,a i tv" -.. i a�"�,e). wise��to"PI I. power to appliance(tf appltcab.t �1 a!1 c1cctri12. Set thermostat(gas control knob)to desired setting from"HI" 8. Push in gas control knob all the way PILOT BURNER to"LO". and hold in. Repeatedly push the piezo ignitor button until pilot iS ht(Or Use a maich to 1 ?Pt )il( ) J. o3 ttnue to he!d the control knob in fir about one(i)mT luteafter the pilot is lit. Release knob. and 1, V,,il! p T ''' :h0!11d I Pik, f 7;1_ E -y.I r .yyG J Y`ii V�S� � f-�! [.• U r T g-H� jJ. lowest._. - r - fr',3.. f to sc*f <J n = t ` ';' "' oas control knob Slightly and turn clockwise 2. Tuiii off all electric power to appliance if service is to be to"OFF". Do trot force. I perfornicd lif )h)icahlc!. . . 16943-7-0907 ,� .z ♦ �i� f .. i�ten+\aha,w�g,ai'f`.G:,�' ;.p ��! ♦ � B 1�� �, d.�w jiezo Pilot Ignitor Instructions Air Shutter Adjustment(Figure 10) ` Depressing the ignitor button completely causes a spark to occur The air shutter on main burlier is factory set ad 3%32";>p;;,;rr 11 L! the pilot. Yellow flamesoccuron main burnrrousCrr i!3",:re=.von ,rr;bolter 'To i:ighf the pilot,it is important that to c?Cclrodo Lie 1;8"(3ilim utordertoincreaseair shutter open inn.-.hhesi;,rc;r;a;rshutie.<,ilv,i s from the pilot. The spark must oCCur ZE1 t1;c pt,ir,: ihi:pilot flame tl,e air opening to he increases cr cleCrea:;xi."fi_hten 1'1"::c, - ;n hits the thermocouple- air shutter after air shutter J. 0!1 a new instal?atirna.wilh air-111 the a t re. i A.i P, SHUT :Hatch be used.The match will it"ht the pilot •.t� ;;,,,,,lite h:ezo under this condition. There will be a short blue inner flame with a much larger,lighter blue,secondary flame. The burner flame may have a small yellow tip when hot. Dust in the combustion air will produce an orange or lllllli Illflil lllllll IIIIOBI IOI@all MINI 011011 11!"M red flame.Do not mistake the orange or red for ` • 5 � .>r an unproper j yellow flame.Clean main burner by ap?iy:~g co.lr..esScd air into ports-and throat of main burner. ---- AIR SHUTTER IN OPEN POSITION—\ V v W CPARTIAL VIEW FROM TOP OF B URNER Figure 10 leaning Main Burner Orifice and Main Burner 1. Turn OFF gas supply to the heater. Figure 5 2. Turn OFF electric supply to the heater if optional blower, T or SRB-30T is alled in heater. Attention: BF-10,Natural or Propane gas has a front and rear air 3. ReBove ower louver from casing assembly(2 screws). shutter. 4. Remove reflector from casing assembly(2 screws). ) BF-20,Propane gas only has a front air shutter. 5. Inspect interior of casing assembly for accumulation of dust, BF-30,Propane gas only has a front air shutter. lint or spider webs. If necessary, clean interior of casing assembly with a vacuum cleaner or apply air pressure. Do not damage any components within casing assembly when you are cleaning. 6. Remove main burner orifice from orifice holder. 7. Apply air pressure through main burner orifice and orifice holder to remove dust,lint or spider webs. 8. Apply air pressure into main burner to remove dust, lint or spider webs. 9. As parts are being replaced in reverse order, check for gas leaks at all gas connections before lower louver is replaced onto casing assembly. 1 L•>+3-1-0907 Page 1.1 �I PILOT FLAME CHARACTERISTICS I The correct Hanle will be blue and!,vill extend bevond the thermos . A couple. The flame will surround the thermocouple just below the tip. A slight yellow flame may occur where the pilot flame and 0 B main burner flame meet. 0 0 -4 0 1 . OFigure 12 0 Warning: Never use needles,wires,or similar cylindrical objects to clean the pilot to avoid damaging the calibrated ruby that controls Figure 11 the gas flow. Oxygen Depletion Sensor Pilot.(Figure 12) When the pilot has a large yellow tip flame, clean the Oxygen Depletion Sensor as follows: 1. Remove pilot from main burner assembly, see "Appliance Maintenance",Page 13. 2. Apply air pressure through the holes in the pilot indicated by the arrows in Figure 12. This will blow out foreign materials such as dust,lint and spider webs. THERMOSTAT OPERATION To ignite main bunter, rotate gas control knob counterclockwise The LO and Hl setting has temperature ran geofapproximate ly55°F toward HI setting. To shut down main burner, rotate gas control (I 2.78'C)to 90°F(32.22'C),respectively.This is the temperature at knob clockwise toward LO setting. the hydraulic thermostat bulb not the room temperature. The owner BF-10 is advised to determine the particular heat setting that is desired for The gas control has an input of 10,000 Btu/HR (2.9 KW/H). comfort,as heating requirements are different for every owner. The hydraulic thermostat bulb is located at the casing assembly Attention: If the owner does not want the main burner to ignite bottom. and turns the gas control knob to the Lo setting,the main burner ,... will still ignite if,the temperature at the hydraulic then7tostat bulb The�at;Glir Ol tI'.�l jili.i?ic.S fro; d 11' 1ltl?.:1;'111lpUt Ot c4,5t�0 13th;� �J.'1. (12.7KeC): - ;� illptl'. of 20,000 CleSlred, tUt7l the gas control knot, to, the 1"! (5.9K Wil t)for L11 gasy(.ill setting}or tf,000 BLUER(5.3 Position. for Natural Gas(HI setting).The hydraulic thermostat bulb which is located at the casing assembly bottom adjusts the main burner flame between minimum input and maximum input. i'hc gas control.inodulates froln a nlinin-urn input of 8,500 BtUiI R 00tFl .,c.1.,C)sal 'v'.11J lnii.`.. .. -..- . . - . . lSlht uw ]t't, !OpU,t. ... - - .. ii}rtt;,...iC'liiC'i.i. l :)IS."i l'.it Cl `I, :ilii burlwr Ilall:e tall! .h: fl: 20 ;if Glass i aroval,Cleaninb and Glass V.Cplaceirienf To Remrve.Gas Valve From Casing Assembly Remove chrome grill from reflector. 1.. 1. 7 tern OFF gas supply to the heater. 2. Slide glass upward to remove glass from chrcmc crd!. 2. Turn OFF electrical supply to the heater ii'o t:ionai bio vcr. 3. --can!Mass with anon-abrasive hl USChold Mass cle;{ncr and SP..13-?ST or SRI; =0'I is in l:;xlt.:. '• _, _ '. - ..c,lf.\�C. �_,a1 c]- 1i,tU ca ldSti1\'1t11-rallsonchrorncgrriliil ��i,�e ,,:�.t(�'uli'.Y.vii -+- Rcillove reflector flonn casing assembly (2 i c,chrome Grill. Remove upper louver front Cash`assC:;li)ly f1h'Cll Ch701)7C grill onto reflector. 6. If i;l5talied,remove optional blo cr assembly ,jC C V51. Warning:Do not operate unvented room heater without glass/ 7. Disconnect inlet supply tubing, outlet supply tubing, pilot chrome grill attached to reflector. supply tubing and thermocouple lead from gas valve. 8. If heater is attached to wall, disconnect gas supply line from To Remove Pi lot From Main Burner Assembly =.:1. Turn CFF gas supply to the heater. inlet rcgillator. 2. Turn OFF electrical supply to the heater if optional t)io `cr, 9. Remove heater.from wall. SRB-1 gT or SRB I0. Rm eove gas valve bracket from casing assembiv(4 sci ews to -30T is installed in heater: be removed are located on casing assembly back). 3. Remove lower louver from casing assembly(2 screws). 11. Remove hydraulic thermostat bulb from thermostat bulb clip 4. Remove reflector from casing assembly(2 screws). 5. Disconnect pilot tubing from riot see Figure located at casing assembly bottom. P g p ( gore 12,Page 12). 12. Remove gas valve from gas valve bracket. Grasp nut A with a wrench when removing nut B with a second 13. As parts are being replaced in reverse order,check for gas leaks wrench. at all gas connections before upper louver,reflector and lower 6. Remove pilot from pilot bracket(2 nuts). 7. As parts are being replaced in reverse order, check for gas louver are replaced onto casing assembly. leaks at all gas connections before lower louver is replaced To Remove Main Burner From Casing Assembly ' onto casing assembly. 1. Turn OFF gas supply to the heater. To Remove Main Burner Orifice From 2• Turn OFF electrical supply to the heater if optional blower, Main Burner Assembly SRB-18T or SRB-30T is installed in heater. 1. Turn off gas supply to the heater. 3. Remove lower louver from casing assembly(2 screws). 2. Turn off electrical supply to the heater if optional blower, 4. Remove reflector from casing assembly(2 screws). 5. Disconnect supply tubing from orifice holder. SRB-18T or SRB-30T is installed in heater. 6. Remove main burner assembly from casing assembly (2 3. Remove lower louver from casing assembly(2 screws). screws). 4. Remove reflector from casing assembly(2 screws). 7. Remove air shutter(s) from main burner. BF-10 Natural and 5. Disconnect supply tubing from orifice holder. LP has two (2)air shutters,BF-20 LP has one(1)air shutter 6. Remove orifice holder from venturi of main burner assem- bly. .and BF-30 LP has one(1)air shutter.Attach air shutter(s)to 7. Remove main burner orifice from orifice holder. new main burner assembly. 8. As parts are being replaced in reverse order, check for gas 8. As parts are being replaced in reverse order, check for gas leaks at all gas connections before lower louver is replaced leaks at all gas connections before lower louver is replaced onto casing assembly. onto casing assembly. 16943-7-0967 TROUBLESHOOTING SYMPTOMS-POSSIBLE CAUSES AND CORRECTIONS I. Spark electrode does not produce spark. b. INTERLOCK latching, a. Shark electrode broken-replace. b device 1 se 'I i"hiino. �c is opera Cvc. Instructions,":Page f0, Step 9. b: ignitor wire ?tidy riot be attached to spark electrode - c. Thermocouple lead not tightened into gas control -tighten attach. thermocouple lead. c. Ignitor wire damaged-replace. d. Pilot flame not surrounding thermocouple-clean pilot,see d. Piezo ignitor defective-replace. Figure 12,Page 12. 2. Spark electrode produces spark beat pilot does Ilght. e. Inlet gas pressure too low contact gas supplier. a. No gas to heater- turn on gas. f. Thermocouple defective-replace pilot. b. PILOT position not properly aligned-turn gas control knob g. Gas control defective-replace. to PILOT position and depress. 4. Main burner does not ignite. c. Pilot is blocked from spider web or dirt- clean pilot, see a. Main burner orifice is blocked - clean, see Figure 12,Page 12. Flame Characteristics,"Page 11. "Main Burner 3. Pilot flame does not stay "ON" when control knob is b. Inlet gas pressure too low,contact gas supplier. released. 5. Heater keeps shutting"OFF"during normal operation. a. Control knob in PILOT position not completely depressed a. Pilot is blocked-clean pilot,see Figure 12,Page 12. or held in long enough. b. Inlet gas pressure too low,contact gas supplier �j a S" ., 1 - ]y k i h�� i s� cFP,q%n ��•s�w.�ti=r'a .rte`, Parts can be ordered only through your service person or dealer.For best results,the service person or dealer should order parts through the distributor.Parts can be shipped directly to the service person/dealer. All parts listed In the Parts List have a Part Nr lax? g parts. first obtain,lie Model Number from the lame it ±�ci ! t i' tt ,JC ) +ilu 1hC DesCl,�rt 011 0 "c Ch p 111 1Strat1031 slid tis,. r'+ a n ( f art floln the fotlowing appropri- ,3�sz-� o n 'a,, t..,s bn atinn. ... L .it - - s '- ' '.. D-'P,' t or ht s.r ] - - - - ( u t ll( 1} a,i-c., gc tsutc,+.sed Ott any(ccai hard\4 ?,F slc,e. S(1p!.,C.rts,.c»+.ti!:;••.;ii l poil. a+i cs..fires-r,d ll C<Lt5 S Je,..`...'J G.., c(,i,i,-111. ( l;t lt, sis:n, ' !r 1 1 ,Av 5 l,e�til li t,�.2Q-2623. 16943-7-0907 . c ,M+ACa�"'fa�a.: t4, '•S F". � '�%"�5`t^ to 'i r-�: -r?-^`-'(+- ;e-x ro. � I d h�aq �i;L v�ia+d gra 4,c,IFt PLEASE NOTE: When arctering parts, it is very iunpurtant tlW part number and dc:cription of part coincitic. � y ( Index Part,No. .Y `I� � Index I arl No. ) Description 1 No. Desrrin+io; I F 1 13347 CASING SIDE ASSE!%-IBI.)'-LEFT(BF-]0 ? � P-2'%1 I \dAT�: W IRS'"�;, — T 1 t _ � R\ 1 t 1 Iii-l0\,� 4 1 133-1 As CrNG SIDE ASSt'Oj3°_ , --T >F-30Ii s E! 1_2�� iviAiiv BUittibi?y tr1(E(B)•-20 NAT) 2 Sit-090 CASING BACK(BF-10 BF-201 e-----= 2 MAIN BURN'EK OR,,it^iCF(BF-20 LP(3) � 2 SR-041 CASING BACK(BF-30) 25 P-2I i MAIM BURNER OkIr'lCE(BF-30 NAT) 3 R-2313 PIEZO IGNITOR 25 P-185 MAIN BURNER ORIFICE(BF-30 LPG) 4 11231 FAN CONTROL BRACKET(BF-10) 26 P-212 ORIFICE HOLDER 5 SR-008 CASING SIBE.ASSEMBLY-RIGHT 27 .10424 AIR SHUTTER(BF-10 NAT&LPG)(BF-20 6 R-1992 BULB CLIP I &BF-30 LPG ON1.2i 7 SR-076CASING LOUVER-TOP(BF-10 BF-20) 28 10539 TUBING'-GAS VAL VE TO PILOT 7 SR-017 CASING LOUVER-TOP(BF-30) (BF-10 BF-20) 8 SR-077 HEAT SHIELD(BF-10 BF-20) 28 10540 TUBING-GAS VALVE TO PILOT 8 SR-018 HEAT SHIELD(BF-30) (BF-30) 9 SR-075 REFLECTOR SHIELD REAR 29 R-6306 PILOT ASSEMBLY(NAT ONLY) (BF-10,BF-20) (INCLUDES 30&31) 9 SR-016 REFLECTOR SHIELD REAR(BF-30) 29 R-6308 PILOTASSEi14BLY(LPG ONLY) (INCLUDES 30&31) 10 10420 REAR SHIELD(BF-10,BF-20) 30 R-6310 PILOT THEPN4000UPLE 10 10420 REAR SHIELD(BF-30) 31 R-6309 SPARK IGNITOR 11 10417 REFLECTOR ASSEMBLY (BF-10,BF-20) 32 R-2390 IGNITOR WIRE 11 10475 REFLECTOR ASSEMBLY(BF-30) 33 SR-126 OPTIONAL SRS-18 FLOOR STAND KIT (BF-10,BF-20) 12 10467 CASING LOUVER-BOTTOM ASSEMBLY 33 SR-115 OPTIONAL SRS-30 FLOOR STAND KIT (BF-1Q BF-20) (BF-30) 12 10479 CASING LOUVER-BOTTOM ASSEMBLY " (BF-30) 34 SR-122 OPTTONALSRB-18T BLOWER KIT . (BF-]0 BF-20) 13 R-4979 CHROME GRILL(BF-]0,BF-20) (INCLUDES 34 THROUGH 41) 13 R-4980 CHROME GRILL(BF-30) 34 SR-116OPTIONAL SRB-30T BLOWER KIT(BF-30) 14 R-4993 GLASS(BF-10 BF-20) (INCLUDES 34 THROUGH 41) 14 R-4994 GLASS(BF-30) 35 R-1454 BRASS BUSHING (4 REQUIRED) 15 R-2784 INLET REGULATOR-NAT 36 R-1499 RUBBER GROMMET(4 REQUIRED) 15 R-2480 INLET REGULATOR-LPG 37 SR-196 BLOWER PAN(BF-10 BF-20) 16 10753 INLET REGULATOR BRACKET 37 SR-198 BLOWER PAN(BF-30) 17 12442 TUBING-GAS VALVE TO BURNER(BF-10, 38 VF-068 CORD SET ASSEMBLY BF-20) 39 R-1465 BUSHING-HEYCO#SR5K.N4 i' 12443 TUBING.-GAS VALVE,TO BURNER(BF-30) 40 R-2395 WIRE ASSElvIBLY 18 12437 TUBING.-.INLET REGULATOR TO GAS 41 k-2503 FAN CONTROL VALVE 42 R-2396 BLOWER(INCLUDES MOTOR,FAN,AND 19 R-6563 GAS VALVE(NAT&LPG) FAN HOUSING) 20 SR-113 VALVE BRACKET N/S. SR-219 BLOWER HARDWARE PACKAGE 21 10460 BURNER BRACKET-LEFT N/S SR-216 HARDWARE PACKAGE 22 10422 BURNER(BF-10,BF-20) N/S I R-1976 MIN.RATE SCREW NAT 1.60 22 10481 BURLIER(BF730) N/S, ..R-1977 MIN.RATE SCREW LP 1.00 . ?3 i0.424 AIRSHUTTER(BF-IQ ON LY) 2- 10461 BORNER BRACKET-RIGHT -q - USE ONLY MANUFACTURER'S REPLACEMENT PARTS. USE OF-AN Y OTHER PARTS COULD CAUSE INJURY OR DEATH. 16943-7-0907 _ Pig, 15 ;1 40 39 42 \ 38 2 / 37 5 / T e o Q o / ` ��. • :' 36 e 35 • 23 24 25 26 ® 34 21 /22 _ • \0 i ON r i 29 \ 27 30 ®® 20 19 i � 7 32 � r ,18 4, 0 17, II t 9 i � L- r / 10 16 r 1 \ o0 ' o ' � o i r i r i 12 . , — .-w.TN»s�jss+*.. _ - — - — ;�!.f..-n ...+^�S�!'�AYR'tc�"27't<T-..�y� W,•.•�'y .. for ITatve Itet crcrtn 11ca�Ls -1+5 1;11-2 �r€ B- -30 �t r r n .;.y r 111-0 tU)ed2C Ci tllc; ^_✓t tiiL'C•.!; 1�1�C1j !, cL C; O"1.1C;N'�Y,!•'LOWER Ct s1 3. {� .�Y ?(I'C t)I\�Fit l t70uS7f1f :TVI (. i . ,;.lil':1tCI lS ill`,ittil:'d O17I0 t1)L\l'1!!L%1l oidcrti. l?a._!l;1_ .�: ,:iii\..,.-: t� C C%l, _., f..�7lISltl�r lit i:)t!iC t(,I?r;Ult!OD lel i. �i .F�-j. i fhChCt:il :17USlbC1CI7K)Vl'dlr0lnnthewa�l. Illi�.0 t iiIll> .,!lct:G!1 ihC bsU\\Cl IU)1>..7 SRS-I S or SRS-30 optional floor stand there is adcz!l;ate access the rain ass�:r17b1v wish (,);:;rows rn:)vivai :-ith ;il ui;ti:.nai area available to install the optional blot.\er. iT! V.el: 1. Turn"OFF"gas supply to the heater. 13. Grasp cord set at casing assembly back and plat excess core rt through casing assembly back. Secure cord set in casing assembly 2. Remove lower louver from casing assembly(2 screws). back with the strain relief provided with the optional blower. 3. Remove reflector from casing assembly,(2 screws). 14. Installation of optional.blower SRB-18T or SR13-30 is Remove upper louver from casing assembly(2 scre\vs). colmpicted i. Insert the fan.control wires and the upper portion of the fan con i j {fheaterwa removed frons the wall.in ord-0r to install SI?.;3-l S i or trol through the 3/4" (19mm)diameter hole on the bottom side SP.B-30"f optional ble\ver,cl?eck',c:r2as ieakat;a!gas connech�,lts of the top heat shield. The fan control wires will enter inio the before lower louver is replaced onto casing assembly. top portion of the heater and the fan control disc will be facing the main burner.Attach fan control to the bottom side of the top Attention! After optional blower has been installed use the following heat shield with(2)screws provided with the optional blower. steps to properly align the upper louver and the reflector with 6. Route cord set through 9/16" (14mm) diameter hole on casing the heat shield. assembly back. Insert approximately 3"(76mm)of cord set into A. When replacing upper louver, be sure the bottom lip of upper casing assembly back. louver goes behind the heat shield. 7. When you are facing the front of the heater,position the optional B. When replacing reflector,be sure the top lip of reflector goes in blower assembly onto the top heat shield of the heater. The motor front of the heat shield. wire harness should be facing into the top, right portion of the Excessive Blower Wheel Noise- heater. ATTENTION! If your blower assembly develops a squeal, hum or 8. Attach(1)pin terminal from black(hot)wire,smooth insulation grinding noise,it indicates din or debris on shaft of blower wheel.Use on cord set to(1)socket terminal on fan control wire hapless. the following steps to clean shaft of blower wheel. grommet with brass bushing from end of blower wheel shaft 9. Attach(1)pin tenminal from black(neutral)wire,ribbed insula- 1• Remove red rubber grommet with brass bushing or black rubber g tion on cord set to(1)socket terminal frolm white(neutral)wire b on motor wire harness. opposite motor. 10. Attach(1)pin terminal.on fan control wire harness to(1)socket 2. Clean blower wheel shaft with cotton cloth. terminal from black(hot)wire on motor wire harness. 3. Place i or 2 drops of all purpose oil on END of blower wheel 11. Attach the green ground wire from the motor wire harness and shaft. the green ground wire from the cord set to the bottom right side 4. Replace red rubber grommet with brass bushing or black rubber of the blower housing with(1)screw provided with the optional grommet with brass bushing onto end of blower wheel shaft.. blower. Attention: The red rubber grommet with brass bushing or the 12. With the 1)cater standing upright,position the air discharge open ing black rubber grommet with brass bushing must"snap-back"into of the blower housing downward. Place the bottom flange of the position. 5. Cleaning of blower wheel shaft is completed. GP NG 6P K E 10 HEAT SHIELD O e gRAGKET lgF 10 ONLEW C' FAN CONTROL GROUND WIRE SCR C FAN CONTROL G� `® Ie RCPRe , REFLECTbR ANO I SI1JG ASSEMB�Y ELn0,4Eo FR G # Wiring The appliance,when installed,[rust be electrically grounded in accordance 'xith lir:l rode:nr.rn Ure ahi�_uc�_ufkual c'odcs,��,rt'i,he`a�umai l.leetr- - c:;I Codd. \NS, dr t,`; (Il if an c r mal electrical,ou*rc�is,uiiIized.Th d I' applianc,cisequrppedwtthathree-prong[groundi ng]plug for your protec- 4PT-3 CORP SEi � --G2E_P, Z tion against shock hazard and should be plugged directly into a properly FAN CONTROL SWITCH grounded three-prong receptacle. Do not cut or remove the grounding J prong from this plug. For an ungrounded receptacle,an adapter,which has two prongs and a wire for grounding,can be purchased,plugged into the _---_.____,_ JI __ ungrounded receptacle and its wire connected to the receptacle in _ I� screw. With this wire completing the ground,the appliance cord plug can B be plugged into the adapter and be electrically grounded. Y w BLOWER ASSEMBLY < - CAUTION: Label all wires prior to disconnection when servicing 3 controls. Wiring errors can cause improper and dangerous operation. _ Verify proper operation after servicing. Blower Motor GREEN The blower motor does not have oiling holes. Do not attempt to oil the If any of ft O�'naiwire as supplied with the appliance must be re placed, blower motor. pit st be replaced with type 125"C wire or its equivalent Blower Wheel The blower wheel will collect lint and could require periodic cleaning. If the air output decreases or the noise level increases,it indicates a dirty blower wheel. To clean blower wheel: I. Turn OFF gas supply to the heater. Turn OFF electrical supply to the heater. 3. Remove lower louver from casing assembly(2 screws). WHITE BLACK BLACK BLACK 4. Remove reflector from casing assembly(2 screws). i MOTOR - 5. Remove upper louver from casing assembly(2 screws). 6. Clean blower wheel with a vacuum cleaner. i` 'A1N CONTROL 7. As parts are being replaced in reverse order,check for gas leaks at I m S"i TLN o all gas connections before C. lower louver is replaced onto casing as- U, sembly. CR r? Cl LI Jif — WARNING: CD Unplugging of blower accessory will not stop the heater from cycling. To turn off gas to the unvented heater: Push in gas control knob i slightly and turn clockwise to"OFF." Do not force. NEUTRAL SPT-3 CORD HOT 2 3 t2TS LIST DESCRIPTION - i n 5 R-2396 BLOWER(INCLUDES MOTOR,FAN, 6'�q AND FAN HOUSING) 2 R-2503 FAN CONTROL 4 BL,': l L;�ll117 -1ir5'CO;t'S1.5KNr4. 1 -! 7 (.. t :✓l RD S FT A S CM.B I,t ov,c?PAN(8F-l(?, E3 '- C', . -- l -_ AF 3s r R PAN("3F-301 f� U IBER GRIO MI4E T(1 R E a J ty,ED t 1 r ,S BUSHING (4.R-Of)IS?Li�} ]. =R- BLOWER_IIA.RD�I�AP.E PACILkGc lc 169-43-7-0907.. ' 'LTJ-.-�:v:1 -•A �.I, .��.±:x 1' d �� .C. N y '. ?. -pg,IN,I go, I Ellie MI-Implawmil 16943-7-6907P-ILc 19 J OC! I i KANNAN & PRICONE Plumbing-& Heating Inc. 3 NEST AYER STREET ,y METHUEN M �"'�A 01844 � Datey Phone (978) 685-0880 FAX (978) 683-7003 #Of Pages kannanpricone@yahoo.corn TO: FROM MEMO: An()L)Gc1 WPO-Me i i J-6 Ze6 i Jen,nifer„�Shovlin, 10:37 A.M12,/6/2010, 13F30 Mass Approval Page 1 of1. ! ; i X-Original-To: ml@fwwebb-con Delivered-To: ml@fwwebb.com X-ASG-Debug-ID: 1291649830-20dd56670001-aVTZfm X-Barracuda-Envelope-From:jshoviin@empirecomfort.Com Subject--.BF30 Mass Approval Date: Mon, 6 Dec 2010 09:37:10-0600 X-ASG-Orig-Subj: BF30 Mass Approval X-MS-Has-Attach: . X-MS-TNEF-Correlator: Thread-Topic: BF30 Mass Approval Thread-Index: AcuVW3Ge3QI+Cg7vSj6QQOK+Nox24vr= From:"Jennifer Shovlin" <jshovlin@empirecomfort.Com> i To: "Mike Leone(HAVERHILL 31)" <ml@fwwebb.com> X-Barracuda-Connect: UNKNOWN(10,0.0.9] X-Barracuda-StartTime: 1291649830 X-Barracuda-URL; http;!110.0.0.10:8000/cgi-mod/mark.cgi X-Virus-Scanned: by bsmtpd at empirecomfort.com X-Barracuda-Spam-Score: 0.80 X-Barracuda-Spam-Status: No, SCORE=0_80 using global scores of TAGFLEVEL=1000.0 I QUARANTINE LEVEL=1000.0 KILL_LEVEL=7.a tests=BSF—SC5_SA057, HTML—MESSAGE X-Barracuda-Spam-Report: Code version 3.2, rules version 3-2-2.48645 Rule breakdown below ,pts rule name descRiption 0.00 HTML MESSAGE MY BODY: HTML included in message ! 0.80 BSF_SC5_SA057 Custom Rule SA057 X-Modified-HTML: 6 X-Mailcontrol-Inbound: RI99ee8t7DEvbaGTm9uluxD2gnTQA6RLi25JVYvOYIIU6FNabJ138Q== X-Spam-Score: -1.5 X- _ ilControl A_10^80 00 (www.mailcont(ol,.Com.)on 10.71.0.121 BF30 Mass Approval#63-0508-365 http,://license.reA 5tate.ma.us/RubLic/pl products/pb search.nsp?type=G&manu acturer=Eire+ComFort*Systems% 2C+Inc4model_BF&product=&des5ri.pt;on=c4psize=50, Jennifer Shovlin 5enior Sales Associate i Empire Comfort Systems Broilmaster Gas Grills 800-851-3153 x3387 i 800-843-8648 fax Follow MrBroilmaster on Twitter: I htfip../ltwitter_com/MrBroilmoster Become a fan of Broilmoster grills on Facebook! http//www.facebook:com/help/#/pies/Broilmaster-Premium-6ais_Grills/167217260788?rte of i Click here to report this email as spam. ' • I I I i . I Printed for"Mike Leozre(HAVERHILL 31)" <m.1 a f vwebb.c0M> 12/8/2910 P Location No. ' Date r tt``D ilea ' TOWN OF NORTH ANDOVER O?O+ I•'6 0 ' , Certificate of Occupancy $ Building/Frame Permit Fee $ '• �' Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ UL 8 wConnection Fee $ _ TOTAL f4 rw� ►, �� ,- Building Inspector ` 6248 Div. Public Works LRF,%t�i[TvN0._a APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE I MAP 4-40. LOT NO. 4- 2 RECORD OF OWNERSHIP (DATE BOOK 'PAGE ZONE SUB DIV. LOT NO. rI /� gA4 LOCATION bb LacPURPOSE OF BUILDING OWNER'S NAME Ya.ttiN K TO s j/,��,,�, NO. OF STORIES a SIZE y� .�( 2b OWNER'S ADDRESS f` ✓ BASEMENT OR SLAB ( 8 Ckaw u.t�, C.•rt� wc,¢ ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME SPAN DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET -I Q $ / POSTS DISTANCE FROM LOT LINES—SIDES � � / REAR 3 0-0 GIRDERS AREA OF LOT f V 0—LA10- FRONTAGE ,�70 / HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW! VlA SIZE OF FOOTING % IS BUILDING ADDITION y /,(per MATERIAL OF CHIMNEY IS BUILDING ALTERATION `C7""` Uo,� ff IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE (AP/,L IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST 0 SEE BOTH SIDES EST. BLDG. COST � 3000 PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. FT. PAGE 2 FILL OUT SECTIONS 1 - 12 EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. - ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED &14,,, (qy [� L±2 I BOARD OF HEALTH SIGNATURE OF CkkNER OR AUTHORI ED AGENT F E E PERMIT GRANTED � � OWNER TEL.# 470-W?- PLANNING BOARD CONTR.TEL.# 19 CONTR.LIC.# BOARD OF SELECTMEN / � BUILDING INSPECTOR a �fl BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION I 8 INTERIOR FINISH CONCRETE -JII 3 1 2 13 CONCRETE 81.K. PINE BRICK OR STONE HARDW D — PIERS PLASTER _ DRY WALL _ UNFIN. 3 BASEMENT AREA FULL FIN. B'M'TAREA _ '/. 1/1 '/ FIN. ATTIC AREA _ N_O B M FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH ASPHALT SIDING HARDW D ASBESTOS SIDING _ COMMON VERT. SIDING ASPH. TILE _ STUCCO ON MASONRY STUCCO ON FRAME B I KATTIC STRS. & FLOOR I_ BRICK ON FRAME NRY CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME SUPERIOR I� POOR ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE I HIP BATH )3 FIX.) GAMBRELMANSARD TOILET RM. (2 FIX.) - FLAT SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY - WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. &COLS. STEAM STEEL BMS. 6 COLS. HOT W'T'R OR VAPOR WOOD RAFTERS AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL B'M'T 2nd ELECTRIC Ist 13rd NO HEATING g r a Y FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state law, regulations or requirements. ****************Applicant fills out this section***************** � APPLICANT: t O-,--MK°ti`c1 I JPhone �iv�) 7 L _ e LOCATION: Assessor's Map Number Parcel Subdivision Lot(s) r Street 6 6 S `' �``^ a" ""ems St. Number 66 ************************Official Use Only************************ RECOrTND,ATIONS 07 TOWN AGENTS: Q� ' Date Approved " Conservation Administrator Date Rejected Comments Date Approved Town Planner Date Rejected v � Comments Date Approved Food Inspe�ct/or-Health Date Rejected Date Approved Septic Inspector-Health Date Rejected Comments . i�eL�y /N Public Works - sewer/water connections - driveway permit Fire Department Received by Building Inspector Date Town of North Andover BUILDING DEPARTMENT Homeowner License Exemption (Please print) DATE JOB LOCATION L � Number Street Addres Section of town "HOMEOWNER" C' An_ ova Wo"', (J "6 Z°• -1� 07) Name k lHome Phone Work 11hone PRESENT MAILING ADDRESS ( (' l..o.r4 �`L$� rC�� ,�_ City/Tovih State Zip code The current exemption for "homeowners" was extended to include owner occuoied dwellings of six units or less and to allow such homeowners to engage an individual for hire who does not possess a license , provided that the owner acts as supervisor . (State Building Code , Section 109 . 1 . 1) DEFINITION OF HOMEOWNER: Person(s ) who owns a parcel of land on which he/she resides or intends to reside , on which there is , or is intended to be, a one to six family dwell- ing , attached or detached structures accessory to such use and/or farm structures . A person who constructs more than one home in a two-year period shall not be considered a homeowner . Such "homeowner" shall submit to the Building Official , on a form acceptable to the Bulding Official , that he/she shall be responsible for all such work performed under the building permit . (Section 109 . 1 . 1 ) The undersigned "homeowner" assumes responsibility for compliance with the State Building Code and other applicable codes , by-laws , rules and regulations . The undersigned "homeowner" certifies that he/she understands the Town of North Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements . HOMEOWNER ' S SIGNATURE— APPROVAL IGNATUREAPPROVAL OF BUILDING OFFICIAL Note : Three family dwellings 35 , 000 cubic feet , or larger , will be required to comply with State Building Code Section 127 . 0 , Construction Control . i I � I , I � , I i ' I I -I-- I I , I � I I I-- I 1. :. � .�.. �----�----'--- ----- - - - I� i I �1. Z� ' ; .• ' i I I N I -- I 1 ! r IL l � - -- -- `r, - -- - _ --- - a-I--- -� I fi j i I I t4(14 �— - Ov W 007,J- i� Im ,s ti to nor 1 IVO ---- ,,�- T R fy LCL 6�d o+ FRENCHY'S CONSTRUCTION FRAMING 12 DOUGLAS AVENUE METHUEN, MA 01844 (508) 97-5m5O5¢ G 7 [ [ v ��(i DATE TO DESCRIPTION AMOUNT F'RoN1` V t PT- 00 - --- - _ - - TR it ZX ti �ti rill, FRENCHY'S CONSTRUCTION 61-A FRAMING 12 DOUGLAS AVENUE METHUEN, MA 01844 (508) 975-3050 DATE TO DESCRIPTION AMOUNT PLCrl PLAN 66 Lacy Street North Andover, Massachusetts Buyer: Waun-Kong and Jo Fung-Chun ,clang Op Scale: 1" = 501 \ September 22,1980 \ f Lor *6 \ 0:fer to N'-FD. BcOk /335, 1 I " ' LST �5 •� ' Anea 105"4c, WTAh a 'o L,c• CTE: This is not a .survey and, is , 5t�c to be.used for mortgage '4 purposes only. N.B.- . Do not use offsets for establishing i lot lines for the erection of fences, # walls, hedges_, etc. I -hereby certify, that the building on 1 this :proper y` is located as shown on plan and ec'��s�`�.' com i.e6� t� tle 9pnin set back requirements I P�� �- : ' g q r of the Town .pf North Andover. NOT APPLICABLL r0 FLOOOILAIP J CYR ENGINEERING SERVICES, j 300 CATIAL STREET LAWRENCE, MASSACHUSETTS i NORT' Town of 4Andover ON No. 2811 Z ` l o� `� oCH dover, Mass., y '0 19 ). %ps°FATED p'PG,`'�� 1 H 4 BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT...... ..x� /4001JAd .......... ........ .. ...... .Aot........................ Foundation has permission to erect-049.1t4............. buildings on .. ,, . .4... ..go ..r.T................................ Rough to be occupied as....t �..�,� i '.�D..N ..00 . .. IIr e.......... Chimney ' e 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 PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR •IN Rough 04&&. UILD.... .... ... Service BINSPECTOR 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 Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT Burner PLANNING FINAL e � CONSERVATION FINAL street No. G e Smoke Det. nr%airn ile►ATrn CINAI v �y� nPh/nAIAV FniTRV PERMIT __ _ /� �. r e pood I 014 � USS 6� �� TV1�n1 S e 0,40TS ` 'o k'v.-) r1 TS ,1 t�Q Poi, d� r( 2e 4ley P� shy d do 61 f� jSr yds Dom� Q✓ncz 81;1,Q-r U)II( �cLve- 15 r P /fir, 11 V�d�h��' �la✓�S �� Prune, 4 Gw� Ove I y KENNETH W.BROWN Consulting Arborist CARPENTER - COSTIN Certified Arborists-Landscape Architects Swampscott aq Middleton Hamilton (781)598-1924 (978)750-8411 (978)468-2293 � � Oz c�`ai c f�o�I RJ6v1 �, C/3A� O WK e4- !�� W O T W 00 ;A1t1AGG sZj.� �.G M E►.J T O ,� v 1 W rt <O � Q zw 0 � / �.�®�•� �.-.,rte--.�,-�+�..,�,,� � �F� �� �� � .�.�`'�',� �'�`'� ;c:ss��,�� / �ts+.tia�/,.'; =-'=�. � •7;�� f � �, �`"t` ...:,r'��Bt'i'tt :' � �. :.�c�_:�` -i�'ar':1``�.�� � � . Nell r• �.r}: �5.' •i�:s.Ta-I�-� .itl Y,. y ��� a.: ?;1\� '� �,- -.t.c� :Q'�.j W;����� .'TT?�,-. �� ►�a�.'r�`�•.�}!`r'il;�•``.1 •t,,� :�r4i ;��.'r. ./l�;\:'i•:~�'.�. �, ., r j1 ._`.11 ti a1 .'��' .7 �..,:�/�!��:r".•� �r�.���' �ri•�•�• r.�t� �./. Vi�'.� s,,'� W �i t( �,�,t�'tti�•��_y� � `O4Cl�T� •L \ 1 1t.s Cr��.na w+ i �tu��wa t'(� �t I \ •T i to- -= w ftL,,T APO NY r � i osao tosv HYto OIL/.HT ' r-Ak Li Tce Ram T� 66 LACY STREET I 2101105.D-0049-0000.0 a , 11 North Andover Board of Assessors Public Access Page 1 of 1 ,koRT►1 1.Qvkm Of Worth JAJ 4jovelr Property Return &soc w„s Return to the Home page click on logo Record Card Parcel ID:210/105.D-0049-0000.0 Community:North Andover SKETCH PHOTO New Search Click on Sketch to Enlarge Sales No Picture icturQ Summary Residence Available Detached Structure Condo Commercial Comparable Sales Location: 66 LACY STREET Owner Name: ROBINSON,CRAIG J. ROBINSON,SUSANNAH R. Owner Address: 66 LACY STREET City: NORHT ANDVOER State: MA ZIP:01845 Neighborhood: 6-6 Land Area: 1.05 acres Use Code: 101 -SNGL-FAM-RES Total Finished Area: 1836 sqft ASSESSMENTS CURRENT YEAR PREVIOUS YEAR Total Value: 435,300 399,800 Building Value: 204,000 189,600 Land Value: 231,300 210,200 Market Land Value:231,300 Chapter Land Value: LATEST SALE Sale Price:379,900 Sale Date: 03/13/2003 Arms Length Sale Code: Y-YES-VALID Grantor:WANG,JO SUNG-CHUN Cert Doc: Book:7608 Page: 203 http://csc-ma.us/NandoverPubAcc/j sp/Home.j sp?Page=3&Linkld=990653 10/5/2007 Commonwealth of Massachusetts RECEIVED City/Town of SJUL 14 2014 ystem Pumping Record Form YS 4 TOWN OF NORTH ANDOVER HEALTH DEPARTMENT DEP has provided this form for use,by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using.this form, check with your local Board of Health to determine the form they use.The System Pumping Record must be submitted to the local Board of Health or other approving authority. A. Facility Information 1. System Location: Left i ht front of htouAildifig, Left/Right rear of house, Left/right side of house, Left/ Right side of building, Left/Rig ron Left/Right rear of building, Under deck Address City/Town State Zip Code 2. System Owner. Name Address(if different from location) City/Town ' State- Telephone Number i B. Pumping Record 1. Date of Pumping Date 2. Quantity Pumped: Gallons 3. Type of system: ❑ Cesspool(s) Septic Tank El Tight Tank ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes No If yes, was it cleaned? ❑ Yes ❑ No; 5. Condition Vofstem:r� 1''l 6. System Pumped By.- Nell y:Neil.Bateson F5821 Name Vehicle License Number Bateson Enterprises Ince Company 7.jSjgHgaule ere contents were disposed: Lowell Waste Water Date t5fomi4.doc•06/03 System Pumping Record•Page 1 of 1 INSTALLER PROJECT MANAGEMENT OBLIGATIONS As the North Andover licensed installer for the construction of the septic system for the property at �v �fl G��/ relative to the application of o Q yr dated l/- �f-d cL for plans by and dated with revisions dated I understand the following obligations for management of this project: 1. As the installer I am obligated to obtain all permits and Board of Health approved plans prior to performing any work on a site. I must have the approved plans and the permit on site when any work is being done. 2. As the installer I must call for any and all inspections. If homeowner, contractor, project manger, or any other person not associated with my company schedules an inspection and the system is not ready then item three shall be applicable. 3. As the installer I am required to have the necessary work completed prior to the applicable inspections as indicated below. I understand that requesting an inspection, without completion of the items in accordance with Tile 5 and the Board of Health Regulations may result in a$50.00 fine being levied against my company. a) Bottom of Bed - generally first inspection unless there is a retaining wall which should be done first. Installer must request the inspection but does not have to be present. b) Final inspection - Engineer must first do their inspection for elevations, ties, etc. As-built or verbal OK from engineer must be submitted to Board of Health, after which installer calls for inspection time. Installer must be present for this inspection. With pump system all electrical work must be ready and able to cause pump to work and alarm to function. c) Final Grade Installer must request inspection when all grading is complete. Does not have to be on site. 4. As the installer I understand that only I may perform the work(other than simple excavation) required to complete the installation of the system identified in the attached application for installation. I further understand that work by others unlicensed to install septic systems in North Andover can constitute reasons for denial of the system, and/or revocation or suspension of my license to operate in the Town of North Andover; significant fines to all persons involved are also possible. 5. As the Installer I understand that I must be on site during the performance of the following construction steps: a) Determination that the proper elevation of the excavation has been reached b) Inspection of the sand and stone to be used. c) Final inspection by Board of Health staff or consultant. d) Installation of tank, D-box, pipes, stone, vent, pump chamber, retaining wall and other components. 6. As the installer I understand that I am solely responsible for the installation of the system as per the approved plans. No instructions by the homeowner, general contractor, or any other persons shall absolve me of this obligation. Undersi ed Licensed Septic Installer Date. - l d Disposal Works Construction Permit 4 COMMONWEALTH OF MASSACHUSETTS Y EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address:_66 Lacey Street _North Andover Owner's Name: Yaun-Kong Wang_ Owner's Address:_34585 Wells Avenue_ _Fremont,CA 94555_ Date of Inspection:_11/15/2002_ Name of Inspector:_Neil J.Bateson_ Company Name: Bateson Enterprises Inc._ Mailing Address:_111 Argilla Road_ _Andover,Ma.01810_ Telephone Number:_(978)475-4786_ CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: _XT Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority j1 ,,bFs Inspector's Signature: - �,-�Date: _11/15/2002_ The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection.If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving authority. Notes and Comments:After permit from B.O.H.,install new D-Box,inspection from B.O.H.,septic system now passes Title 5 Inspection. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. WELL DATABASE ADDRESS: AGE OF W r : WELL DRI ER: WE FERMIT,T: ? WELL LOCATION: —Vi=PE2 I=-DATz-:- �- DEPTH OF WELL: � _._=E:OF WELL: a- DRII.= b. DUG TYFEOFWA=EF-kRING ROCK: WA=ANA.LYSIS:DA.TF-.._ - . =(TE�VGANESE:. Y N' HLC IRON: Y N OTEER_CONT.AMNANTS. N - --- W T r DAT_A.EA SE ADDRESS: �^G AGE OF WE'i - ? W LL DRILLER: ? WELL PEST T: WE LOCATION: WELL PERINETDATE: EPTH OF WELL: TYPE OF WEl':: a. DRILLED b. DUG', c UN-KNIC WL\1- \,, TYPE OF WATER BEA.�iG ROCK: WATER ANALYSIS DATE: HIGH N ANGANESE: Y N HIGH IRON: Y N OTI-PE't CONTANMgA-tTS: Y N Town of North Andover, MA Watershed Septic System Servicing I.eport Date:— Homeowner: ate:Homeowner:_ Pi mper :_ / 5� ,1���-z✓ Street _ Ac dress:_ 1 �_ Phone _ (� — � PY:.one Nature of Service: Routine Emergency Observations: Good Condition Full to Cover Baffles in Place c/ Leachf ield Runback Excessive Solids Heavy Grease L(,/ Roots ) Other (Explain) Description of Work: Comments: FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state law, regulations or requirements. ************�*/***Applicant fills out this section***************** APPLICANT: t a`'" K11`1 �J 4;111 Phone (Avg) 7o cl 7 Z e LOCATION: Assessor's Map Number Parcel Subdivision Lot(s) r Street 6 6 StY �� �� St. Number 66 ************************Official Use Only************************ RECOMMENDATIONS OF TOWN AGENTS: Date Approved Conservation Administrator Date Rejected Comments Date Approved Town Planner Date Rejected V i Comments Date Approved Food Inspeecctjor-Health Date Rejected Date Approved /0 Septic Inspector-Health Date Rejected Comments 7 /✓L� �/� Public Works - sewer/water connections - driveway permit Fire Department Received by Building Inspector Date Commonwealth of Massachusetts City/Town of I . �!`��D System Pumping Record Form 4 OCT 3 C 2009 wM R DEP has provided this form for use by local Boards of Health. Ci�tWjd�rri�.Q N,.woo e used, but the information must be,substantially the same as that provided here"�4efore-usin his form, check with your local Board of Health tQ determine the form they use. The System Pumping Record must be submitted to the local Board of Health or-,other approving authority. A. Facility Information 1. System Location: Left side of house, Right side of house, Left front of hou Right front of house, Left rear of house, Right rear of house. Left rear of building. Right rear of buil In -- Address ('� (r-�_ � � , �� Y City1rown State Zip Code 2. System Owner: ��� ��c,✓ Name Address(if different from location) CitylTown Sta , , — Code Telephone Number B. Pumping Record C0--L3—cq 1. Date of Pumping Date 2- Quantity Pumped: Gallons 3. Type of system: ❑ Cesspool(s) Septic Tank ❑ Tight Tank ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes No If yes, was it cleaned? ❑ Yes ❑ No 5. Condition of System: V \ � 6. System Pumped By.- Neil y:Neil Bateson F5821 Name Vehicle License Number Bateson Enterprises Inc Company 7. Location ere contents were disposed: L.S.D Lowell Waste Water Signature of Hauler Date t5form4.doc•06/03 System Pumping Record.Page 1 of 1 f �+ .Kt�y 7�� ,11 c.♦ Trr r ��� yo �r BOO �. � �-` a� R l�d._k �h/ 1 �4• to � ,t,o ��' �..- _ - U /• 05 AcR �S s a ^'1 t tX13TinrG t �r o JJ, i L Y � �, . IrF I t . I . E BOARD OF HEALTH NORTH ANDOVER, MA 01845 978-688-9540 APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT DATE: ��' �I _ Q CURRENT INSTALLER'S LICENSE# LOCATION: LICENSED INST R: f SIGNATURE: TELEPHONE#j JF CHECK ONE: REPAIR: V.. NEW CONSTRUCTION: L -�Z,x ��ly IF NEW CONSTUCTION, PLEAS TTACH FOUNDATION AS-BUILT. Administrative Use Only l 6A:6(a Fee Attached? Yes �r No Project Manager Ob. Yes No Foundation As-Built? Yes No Floor Plans? Yes No Approval � Date: Q � �.__ f COMMONWEALTH OF MASSACHUSETTS Z EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS d DEPARTMENT OF ENVIRONMENTAL PROTECTION OF NORTH ANDOe � BOARD OF HEALTH Q� SV TITLE 5 " OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSM-EN—S • SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A / CERTIFICATION Property Address:_66 Lacy Street- -North treet_North Andover_ Owner's Name:—:_34585 Wells Avenue_ _Freemont,CA 94555 Date of Inspection:_9/13/2002_ Name of Inspector: Neil J.Bateson_ Company Name:Jateson Enterprises Inc._ Mailing Address:_111 Argilla Road_ _Andover,Ma.01810_ Telephone Number:_(978)4754786_ CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems.I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: Passes X Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fa' Inspector's Signature: t Date: _9/13/2002_ The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection.If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving authority. Notes and Comments:Needs d-box replaced. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. • Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 66 Lacey Street _North Andover_ Owner: Wang Date of Inspection:_9/13/2002_ Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: _X_ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired.The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass. Needs d-box replaced. Answer yes,no or not determined(Y,N,ND)in the for the following statements.If"not determined"please explain. _N_The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: _N_ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: �N The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: Page 3 of 11 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 66 Lacey Street North Andover Owner• Wang Date of Inspection: 9/13/2002_ C. Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health,safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: _ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. _ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well".Method used to determine distance "This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address:_66 Lacey Street_ _North Andover_ Owner: Wang Date of Inspection: 9/13/2002_ D. System Failure Criteria applicable to all systems: You must indicate`yes"or"no"to each of the following for all'inspection: Yes No _No_ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool _No_ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool _No_ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool _No_ Liquid depth in cesspool is less than 6"below invert or available volume is less than'h day flow _No_ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped _No_ Any portion of the SAS,cesspool or privy is below high ground water elevation. _No_ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. No Any portion of a cesspool or privy is within a Zone 1 of a public well. _No Any portion of a cesspool or privy is within 50 feet of a private water supply well. _No_ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form.] No (Yes/No)The system fails.I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no the system is within 400 feet of a surface drinking water supply T _ the system is within 200 feet of a tributary to a surface drinking water supply _ the system is located in a nitrogen sensitive area(interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes"in Section D above the large system has failed.The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. Page 5 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 66 Lacey Stmt _North Andover_ Owner: Wang Date of Inspection: 9/13/2002_ Check if the following have been done.You must indicate"yes"or"no"as to each of the following: Yes No Yes — Pumping information was provided by the owner,occupant,or Board of Health No Were any of the system components pumped out in the previous two weeks? Yes_ _ Has the system received normal flows in the previous two week period? No Have large volumes of water been introduced to the system recently or as part of this inspection? Yes_ _ Were as built plans of the system obtained and examined?(If they were not available note as N/A) Yes_ _ Was the facility or dwelling inspected for signs of sewage back up? Yes_ _ Was the site inspected for signs of break out? Yes_ _ Were all system components,excluding the SAS,located on site? _Yes_ _ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum? _Yes_ _ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes no Yes_ _ Existing information.For example,a plan at the Board of Health. No Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [3 10 CMR 15.302(3)(b)] Page 6 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 66 Lacey Street_ _North Andover- Owner: Wang Date of Inspection: 9/13/2002_ FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design):_4_ Number of bedrooms(actual):_4_ DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms):_600 Number of current residents:_0 Does residence have a garbage grinder(yes or no):_No_ Is laundry on a separate sewage system(yes or no):_No_ [if yes separate inspection required] Laundry system inspected(yes or no): Seasonal use:(yes or no):_No_ Water meter readings:_On well water_ Sump pump(yes or no): Yes_ Last date of occupancy:_Two weeks ago_ CONEVIERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no):_ Industrial waste holding tank present(yes or no):_ Non-sanitary waste discharged to the Title 5 system(yes or no):_ Water meter readings,if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: Unknown when pumped last Was system pumped as part of the inspection(yes or no): Yes_ If yes,volume pumped:_1000_gallons--How was quantity pumped determined?_Measured tank_ Reason for pumping:_Inspect tank&baffles TYPE OF SYSTEM X_Septic tank,distribution box,soil absorption system _Single cesspool _Overflow cesspool Privy _Shared system(yes or no)(if yes,attach previous inspection records,if any) _Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) Tight tank _Attach a copy of the DEP approval _Other(describe): Approximate age of all components,date installed(if known)and source of information:_25 years old 11/12/1977. As built plan_ Were sewage odors detected when arriving at the site(yes or no):_No Page 7 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 66 Lacey Street_ _North Andover- Owner: Wand Date of Inspection:_9/13/2002_ BUILDING SEWER(locate on site plan)X Depth below grade: 24" Materials of construction:-X-cast iron _X_40 PVC other(explain): Distance from private water supply well or suction line:_>1001 _ Comments(on condition of joints,venting,evidence of leakage,etc.):_4"Cast iron thru wall.3"PVC in house. No leaks. SEPTIC TANK: X locate on site plan) Depth below grade:_12"_ Material of construction:-X-concrete_metal_fiberglass___polyethylene _other(explain) If tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no):_(attach a copy of certificate) Dimensions: 7'x 5'x 4' Sludge depth 8" Distance from top of sludge to bottom of outlet tee or baffle: 24" Scum thickness: 12" Distance from top of scum to top of outlet tee or baffle: 6" Distance from bottom of scum to bottom of outlet tee or baffle:_8" How were dimensions determined:_Subtract scum&sludge depth to baffle length._ Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.):_Pumped septic tank.Inlet baffle ok.Outlet battle ok. Depth of liquid at outlet invert.No evidence of leakage._ GREASE TRAP:_(locate on site plan) Depth below grade:_ Material of construction:_concrete_metal fiberglass_polyethylene_other (explain): Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of spurn to bottom of outlet tee or baffle: Date of last pumping: Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): Page 8 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:_66 Lacey Street North Andover— Owner: Wang Date of Inspection:_9/13/2002_ TIGHT or HOLDING TANK: (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Material of construction: concrete metal fiberglass_polyethylene other(explain): Dimensions: Capacity: gallons Design Flow: gallons/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: X_(if present must be opened)(locate on site plan) Depth of liquid level above outlet invert:_1/2 below inverts_ Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box,etc.):_D-box has corrosion holes at water level.Evidence of leakage.Evidence of carryover.Needs new d-box installed._ PUMP CHAMBER: (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:_66 Lacey Street_ _North Andover— Owner: Wang Date of Inspection: 9/13/2002_ SOIL ABSORPTION SYSTEM(SAS):_X (locate on site plan,excavation not required) If SAS not located explain why: Type leaching pits,number:_ leaching chambers,number: leaching galleries,number: leaching trenches,number,length: _X_leaching fields,number,dimensions:_1 field 20'x 45'_ overflow cesspool,number: innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etc.):_Soil ok.Vegetation ok.No sign of ponding to surface. CESSPOOLS: (cesspool must be pumped as part of inspectionxlocate on site plan) Number and configuration: Depth—top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): PRIVY: (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): . Page 10 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:_66 Lacey Street_ _North Andover_ Owner: Wang Date of Inspection:_9/13/2002_ SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks.Locate all wells within 100 feet. Locate where public water supply enters the building. House Well V later Garage B A Driveway A to Tank=35' Septic A to D-Boz=42'2" Tank B to Tank=32' B to D-Boz=36'8" 4 D-Boz 20' 45' • Page 11 of 11 II OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:_66 Lacey Street _North Andover— Owner: Wang_ Date of Inspection:_9/13/2002_ SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water 4 feet Please indicate(check)all methods used to determine the high ground water elevation: _X_Obtained from system design plans on record-If checked,date of design plan reviewed:_2/15/1977_ Observed site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health-explain: Checked with local excavators,installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: As per design plan Tel: (978) 475-4786 Fax: (978) 475-5451 BATESON ENTERPRISES, INC. Excavating-Water.& Sewer Lines-Septic Systems&Pumping Service I I I Argilla Road Andover,Mass. 01810 Title 5 Inspection Report Property Address: 66 Lacey Street, North Andover Owner: Wang Date of Inspection: 9/13/2002 My report contained herein does not constitute a guarantee of future usage and the functionality of the existing septic system. Such report issued herewith is merely based upon my observations, and I hereby disclaim any further operation of your current septic system. Neil J. Bateson Bateson Enterprises, Inc. rUOTC: PeOPosED SuBSu A4e-E SEWAGE D/5PM54e- SYSTEM ' r MtlS7' 8E /NSPCC%E D AN, PGOPOSED LOT aRA13/rV6 .�f So,�PTiDitl 3LD SCAZ.E = / ¢O" 44 716 = Fes, /5, /977 Lo-rOWA/E.2: L5GCOr ,oeO El T Es Z,> IVO 6'A ee,46 E D/SPO5,4G- /S 70 QE /�t/SrAe-1-ED 3S (f&(/TE-P— C5TFe&4E—/ Zit/ THE AeOPO.5&n UGUEGL/�t/U, { D s Acpzen, BUNG/14.115 701V� 1 i1,4S5. WETLOCAT/o AY Gol#S , L�Gy sr. AREA IVO" •4�C/DOIJE2 Ni SSS, � � DES/f�t1ER � ��b CL►Mr;�!l��,��^ 4 cTO.SEP/-/ cT BAe SAG,4LL. D t3ENCNMA�K ' 1Q/!/ET /N BZ DK. AT �• N/ESTGI/ARd CleCGE LAc y ST Fo,�eSr Sr.EZ. 127/4- REAO/Nle , MASS. \ r S. Q et- TSL. 4-4 983 4651C7.(J DATA': T4415 - / TYPE OF BU/L D/A/U: 652)ROOM l)t.VELOAA:7 r ; GARAcCE $ CELL.4R PGUMB/NU FAGIG/T/ES- AJOAJ SE6!/AGE rLoW EST/MATE: 1000 G. /? D, X /• 0 Sr G 5 SEPT/G TANk : /DOO GAGGOA-/S f�650.ePT/0N AREA • r `+/ET 'G� r ' ®PEkCOGAT/o,V TEST.5. -A'-/ �`Z -ws '�¢ i+ r , • / ry,. DATE •sr ,� o- TDP ELEt�Ar/oN �2 p,d �PlO /1 �cC` ,�OTTDR /Z"ro 9" DROP 4 /l?/N. M/N. A-VA/ it//1iv M/iv. ` -., • •�- ....� /2p PE.PGDLA T/OrV RATE �Z Mni•�%v. �1iv.�/,v. /f1iv�/N. N/rN /,v. - -� s, -- -- - - Cl cx E.5r PITS #i #z #3 #¢ • --� " 4��\ zo F,!!v• fir• DATE To TOP ELEI/AT/DA/ �� �` ._� V �.. �,\ •..'.,- to"G oA H /Z"PALS SANOA AID i.✓A ��R so/c- TYPES 6O-coq 45E fj WArER rAaLE it""6ZANE� NO �r✓�T r91VQ -GRA `�//��rS�/NS 1nr'!Th/N /4 ll f- LOCAT/ON AJO 44,iV 0YV r'1,n,j,. -2�xf AIA4 -1'Ov_ -6,6 7"4,11"V Q BOTTOM EZEUAT/ON \ TESTS COAIDaC 716D 5Y <7226EP1-1 T.. 84R&A(SAI-L O TESTS N//r"ESSEd BY "e. AAIDO I/Ee- HELI L TN DEPT. PZAA1 �' DEsl�til C,elTErel.4 cS'HEET / OF 2 r - _ _ _ ...+••....- PtTC+-1 Z�/a T �__�''ITC-1-{.. 2� -'-�' �/,�„( <SEALED cJl�/NT, �.SD�/ P. 1/.C. /P�- . 7 r <OR C I p p b CAPPED ��t/D S U 5'-0" /oeeAO,QATED �o.e Ec7u/vA�EA/r� P,4R7-IAL BED Eti/D SECTIOA-1 SCALE FO SPEC/FlC 4 7-/D�t/S - 5'EE 5'ECT/DSV AT LOWE-R RA/i/-/,7-) t • 1�.��T�'IBUT/DAl �X ' r % ¢" CAST'I,PDc./, S=.024 • /DOO QlJL. CONC2ET SEPTYC TANKlie ¢5 f"� 5'OG/1� �.F- <SEALED TO/�lTS � •Caa7.j - ¢"¢S PEie 1'::- .g',A s=.nGLS 14,5 5UR P T/D/-/ .BEO /PG A A/ • t 3� lUoT TO cSCALE ALG F/LG MUST 69rA54/6 e5' FQOM Tf/E ew .4T EL. /23,S An/p MSU .SGoPE /a'i Td &,0406. pQgpr sEAG ED cs6z-EC T OwEL. inl. CRA ��,,�r, 1 L 3S c o 00 moo. p•Q e o 4Poo qi BUS�E� S6 HIFAD �O V U J [� ••• , X/C� �/ d C p a _n i{ I/ y1. !` '/'�+,,,.,.°tet'` �,�•� ,i e e (/. f�/PE O� 0 0 0 _ s ✓ 'ae OdE ALG TOP.SO✓L 4e PRcegsv sAAI.0 ` `• 860AZEA .Q vv �eER�qcE W1771PICG C3 d dR,41/6- rb _ ` -�- 3 ¢ To //z,, VVAS qE1) cV - 119 � GNUS iEG7 STONE Q O O \ �vOUBGE vVASl,E� To MEET A.A.S.4.O. IA M g H,BSOPPT/OA/ &B ,:D cSEC T/O it_/ N m N N11 11 J S,--44 . ' 4NU 43Soeprlory BEO IIGAa! QNv MSEC T/O NS 15/-/EE T O� r i /{lOTc•' ! ��OP0.5ED SUBS!!E'FgGE SEI,t/AC�E I>>SA�SgL <5'YS TEM /� AeOI�O✓6Ed Z07- cTR,4,b1A/* A.F SekPTION 8�D !L�'8 S'CAGE SATE = FE�3, 45 IV?.7 PSVlSED' 77 OWA)&R: ,5—Z0 7- ��0P6AeT/ES 2,) IVo �.9�BAGE D/sPO.5.4-1- /S To GEIVSTQL�ep Lor .5- CFc/TES �5T2EE7` rA/ THE A,LOPD-EZ� DWELL IA16. G� D � ' BG/k'L/A/G 70" 11iI.ASS- 1vr=r -'"'� �''� �+ � •'t LOCAr�aw: GOTS , G� Cy' ,ST A RFA \ M !/ ,4_S= A�clL�D � 4 cT6-56PR cT �AE BAGALL o , h?S. '• • - `a t�E��C MARK% �i/ver /N BLDK. ATGE , / Lt/ESTu/A�2A CIRC Z 4c y ST, rol esr ST/EC. 1 Z7.l4 (v 4t R ✓ DES/U AI O A TA •r}��S �i��,�- ,, TYPE DF QU/L D/A1G� 4 EED�©c�N' !�t�t/EL[./tic, .SEQUA:a E FLO W EST/MA TE: OGS a. A2-0,. ,t r d � SEPT/e-- rAwlA /000 G4G.40^✓s ABsoeP T/aN .4 REA • SD D SQ. FT• 1v�•i'4 z� •�- , SATE 1Z-/-Al., �� + �O � b v�o •jj,,�J TDP EGE!/AT/ON f`�Q.C� EGEt/4 T/o v yro, , . '71 �' S,4TL/.QAT/DA/ /5 AL1/A/. ro 9" DROP ¢ iYl/N. MiN. AVIV. M/n1 P -A T/on/ RATE TE.5r PITS DATE 14e-/-7G TDP 5LEI1A7-/6A/ &„cow SO/C TYPES , Ct74@.S WA TEk rA S L Esrvv / d //'v _/GG/ ..0.dA!/EL. - LOCA T/O A/ BOT TOM ELEVATION //2,57 TESTS COA1,0aC -67DB BY JD SEP y Jr 84,�BAGAL L O TESTS WITNESSED BY : /UD. AAJI)OVEe- A-IEQ�-TIY DEPT lf�LAM DES/4� �.er rE�e/A cS'HEET / OF 2 G �o ��HS 5/vo/1:»_51 (71-Vd I-VW731 Oo ` /Y 1-?3r C?��7 /l/0/1 daos9'� O/ g w q D � Q9h'Sb/N �78/�oCf, . '79 az Q !/vim7np- /r/ CZ"Wr <ZGa'7b&,*7,'VrYOl 7'76' AWPV721;. W Cl ai co ao O o Q�H57d4-1 „8/f' 01 -07 obd'd. - - - ' • �„fes GZI 7757-77 --wvaJ Ol /:O/ gdow /Y9H1 vivy- ,S2 P/Y91X9 1V7W -77/.,11 776' o1 /v V 7d C73?g NO/1 d 2Yos8�7' s�o =s '• a��d 19P 7iNd1 /1d�S �1�a�NOJ 7!/f. 000/ xc� Ivo/ln9/a1.��� L'H tj/a r3�/3'!07 1 d N O/1 J�5' -5'-9S' S - NO/-1 b'J/�/J9dS a'o�> 0 1 (h006 s = diad r - TV 0/_L�3 QN� O3� 7ty/1 t� 114 r- _ +i• ai Eo � S�N� o�ddN� a o � pnz _Id -_� fa Z D.Lld '-----w•- _ _ — -- - A-<fESS 1WAMHOC.E:S s TD BEGOw �7,eA�E <¢ /N. OR LESS ¢n •, �+ Liazu�o LEVEL L,cttuiA THE LETA/C.S S'A4owA, LE✓EL � O,l.l THIS PLAN 544 EE Al-!�E / YP/CAL L 7, %LS ¢ C'.4ST 2,eo,,.1 TEE 0 4 C1F;4C 7-Z-1,e0 ?. 6Q U/VA - 4. ¢`�( '>5TIPPON TEE A �E.vr P.Poouc n M,q�' 3'/4' BE- SUf3ST�rC./rEA e, q 4t/L Y W17 THE 4 A/vo THE DEsic,vE,e. /40,1. 6-RA!/EI- - SUBBASE - - /Z" M/N. -• 1 . - . ' •. • . - _ _ _ _ C__.. •' �SFA vE� �L/B-Bf]sE ,S7EP7-/G 4-A 5 Ale>7- rO SCALE Sep 7-/G TAti//G — cSEGT/D�l B-B A-foT ro cSC4G E - 4 GJ V•- .,u _ V.'' :4 -Q.• -'V•, Q . Q. q � e Q j - , p ' p '/4" 0' Q• Z' el as // \ \ /►• _ \ O-O � Z a 6RA EL 5c,':3-r3L .0/•5 r"C Z3UT/O.t1 D/STR/SUT/ON BOX SECT/DNS SeALE S,E•PT/G TANK F1-A,(-1 iL/OT TO `cSCAG E DETAIL 5 FOR TODD GAL . COAIC. SEPTIC 7,vk CO/vc. D/sr-,F'iBuriory Box SHEET 2 OF d r a NORTH ANDOVER l� SUBSURFACE DISPOSAL SYSTEM CHECK LIST I. General Information Reg. 2. The submitted plan must show as a minimum: (a) y-the lot to be served (b)e! location and dimensions of the system (including reserve area) (c)(4design calculations (d),,,-calculations showing required leaching area (e)6z- existing and proposed contours (f),,-- location and log of deep observation holes - distance to ties (g),L location and results of percolation tests - distance to ties (h)rLlocation of any wet areas within 100 ' of the sewage disposal system or disclaimer Mo/ surface and subsurface drains within 100 ' of the sewage disposal system or disclaimer (j ) location of any drainage easements within 100 ' of the sewage disposal system or Ldisclaimer (k)(✓known sources of water supply within 26C o the sewage disposal system or disclaimer (1 ),-:location of any proposed well to serve the lot (m)ylocation of water lines on the property _ maximum ground water elevation in the area of the sewage disposal system (0)14 a profile of the system (p)�4_rio PVC is to be used in construction (q) 6tlocation of benchmark (r),/-, plan must be prepared by a Professional Engineer or other professional authorized by law to prepare such plans. II. Garbage Disposers III. Septic Tanks Reg. 6.1 (a))`_Capacities - 150% of flow Reg. 6. 7 (b),;LWater table Reg. 6.8 (c)p[ Tees Reg. 6.9 (d))LDepth of tees Reg. 6. 12 (e).Y- Access Reg. 6.18 (f)X Pumping (g) U_Cleanout IV. Pumps Reg. 9. 1 (a) Approval Reg. 9.6 (b) Stand-by power } W 9 V. Distribution Boxes Reg. 10.2 (a) Slope greater than 0.08 D Reg. 10.4 (b) Sump VI. Leaching Pits Leaching pits are preferred where the installation is possible. Reg. 11.2 (a) Calculations of leaching area (minimum 500 S.F. ) Reg. 11.4 (b) Spacing Reg. 11.10 (c) Surface drainage 2% Reg. 11.11 (d) Cover material VII. Leaching Fields Reg. 15.1 (a) ,&-Greater than 20 minutes/inch Reg. 15.1 (b) C(-Area (minimum 900 S.F. ) Reg. 15 .4 (c)y Construction of field Reg. 15 .8 (d)cj�-Surface drainage 2% IX. Downhill Slope (a) Slope y/x = (to be shown) (b) y/x X 150 = (to be shown) �� C.. Y . / SOIL PROFILE & PERCOLATION TEST DATA Town/ i jr No.&Street - . Lot No. ,1 Loc./Subdiv. Plan �(� Owner__ Investigator, , f� Observer � 1 SOIL PROFILES-DATE 1. Elev. 20Elev. 3" Elev. 4'Elev. \� 0 0 0 0 \(1 1 � 1 1 els � 2 2 2 2 3 3 3 44 4 4 4 lV ' 5 5 5 5 6 6 6 6 7 7 7 8 8 8 8 9 1 9 9 9 10 10 10 10 Benchmark Location Elevation Datum Percolation Tests-Date ZQZIZ74 Pit Number 1 2 3 4 5 Start Saturation Soak-Mins. Start Test-Time Dro of 3"-Time Dro of 6"-Time Mins.lst 3"Dro Minso2nd 3"Drop Notes & Ske the on Back Frank C. Gelinas & Associa N rth And. LoT �a .Ary �. ,�._�..`..:_�-:•. 17 l T.+l 1+ E. Z '70 001 14) NZ IJl �y l n \ r " � 1 "yam L� �-` �• � Y � � L DoT#�� �� _;�. � r ► . ^�,�� ,,', _�� . 1. 05 / 0 .... 0 -7 -53 Yv -7- . , e Town of North Andover, Massachusetts Form No. 3 f BOARD OF HEALTH 40RTN � F DISPOSAL WORKS CONSTRUCTION PERMIT ,SgACMUSE� Applicant NAME _ ADDRESS TELEPHONE Site Location Permission is hereby granted to Construct ( ) or Repair ( ndividual Soil Absorption Sewage Disposal System as shown on the Design Approval S.S. No.-11"'(-2 CHAIRMA/N,BO A R OF HEA Fee D.W.C. No. .127!c TO: NORTH ANDOVER, MASS 11112- 19 7-7 BOARD OF HEALTH FROM: DESIGN ENGINEER Re: Soil Absorption Sewage System Inspection This is to certify that I have inspected the construction of the said disposal system at G a 7 LSC / -5 North Andover, Mass. SITE LOCATION The grades and construction are as specified in my plans and specifications dated 19 Nolss�� 3 / g. Pro of eg. S `..''Orian Q ( I! A TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAM NATION �ss�cHu�� Permit�i0: Date Received: `��ZJO Date Issued: BIPORTANT: .\pplicant must complete all items on this page— LOCATION a eLOCATION A,��C v`� Print PROPERTY OV\'NER�' � /�<'c�i,r�r�'� --- Print tiIAP NO.:/C� . G PARCEL: U ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES 0 TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential = New Building One family Addition = Two or more family = Industrial Alteration No. of units: Repair, replacement Assessory Bldg _ Commercial Demolition Movin (relocation) = Other Others: = Foundation only DESCRIPTION OF WORK TO BE PREFORMED e� Z_aJ'f /2 i-o/e' go(u�-Slo Identification Please Type or Print Clearly) OA'NER: Name: �,+��'�� ���/�'�`� Phone: Address: �,�/. s% 10� �W -z CONTRACTOR Name: �X� /� ���i� Phone:-, P EY Su urs isar"s Construction License:_ P• Date: Home ImprovExp.License: //���'� P• Date: ,,55? ` %RC'1-11-1-ECT. E \C[\'EER \gmc: Phone: .a.ddress: FEE St 'i�EDC LE: 3(Lt�I.iG i'E'11,i11T:.5i0. FSR yi 100.06 GF THE'TOT.IL d ST1,6GI TSD C9ST 3.-ISE!�.0'N Total Project Clost :$-_-_-,1 x10.00- FEE: . r'I,cck NO.: ReceiptNo.: -- i„i{ TYPE OF SEWARGE DISPOSAL _ TanningAlassage Body .art S�%imming Pools Public Seer _ Tobacco Sales Food Packaging Sales Well _ -- _ _ Permanent Dumpster on Site _ Private(septic tank,etc. Electric Meter location to project OTE: Persons contracting iih unregistered contractors aIo not have access to the i,► arra nt irnd Signature of.lgent Okrner Signature of Contract ''Z Plans Submitted ans Waived Certified Plot Plan Stamped Plans THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF- U FORM DATE REJECTED DATE APPROVED *PLANNING & DEVELOPMENT ❑ i ❑Water Shed Special Permit E Site Plan Special Permit J Other COMMENTS DATE REJECTED DATE APPROVED /CONSERVATION iJ COMMENTS DATE REJECTED 1 DATE APPROVED HEALTH COM i�IEN'TS Lon ng Board of Appeals: �arianee. Petition �o: — 7-mine Decision receipt submitted -:s " .utrnnq 13-wrcl C+xiston: —+ ommcnts 111111C1 its 3uilding Kt'mii.Appru��d and fsSUcd by: `� a MSC Order # j21 g81 MORTGAGE INSPECTION PLAN fors mortgagerpurposesaonlypection LOCATION NORTH ANDOVER MA Q` City or Town State OI �� DATE: March 10, 2003 SCALE: i inch= feet 1 * Certification is hereby made to 1.• �T / _ -� GMAC MORTGAGE CORPORATION that the existing structures shown on this plan are *AWROKIMA'tI� situated on the lot desi?nate0in compliance with the ! 5{{pkc�Pf- / setback requirements of the applicable zoning bylaws of the municipality when constructed. or are exempt from violation enforcement action under M.G.L. Title VII ' Chapter 40A, Section 7. * / This inspection was prepared in accordance with the technical standards for Mortgage Loan Inspections as / adopted by the Commonwealth of Massachusetts ` by 20 - �"15QT" g tared Land irveyor ':�OQ r—i?_(5 M 'G� pu2Po57�s / DEED AND PLAN REFERENCE ESSEX NORTH DISTRICT REGISTRY OF DEEDS Deed Book 4758 Page 308 Plan Book Plan #7535 Certification is hereby made that the structure shown on this plan IS NOT located within a Special Flood Hazard Area as delineated on the map of community No. 2500980009C Effective Date:June 2. 1993 \ By the U.S. Department of Housing & Urban Development. Federal Insurance Administration. 60VEML NOTES A confirmatory survey is advised when structures are / �, shown to be situated at 1 foot or less from property R lines or required setback lines, or when potential � > qq basis ofmmytknowlledge i�fobmatJonaand belief. the A' _ ����� �_;Wz �z MORTGAGE SURVEY CONSULTANTS, INC . � - 126A PLEASANT VALLEY ST. -SUITE 7 - METHUEN, MA 01844 TEL. (978) 975-2700 FACSIMILE (978) 975 0135 'J NORTH ANDOVER BOARD OF HEUTH. r _ NST LLA�L'.i.ON CIIiCk LIST ID APrFOVD1St-` r, .'RGV__i _.__.. — _- --~~. -------- `-EXCAVATION OK _. Date: Date: '/t-�0 77 - - c�^ C(- Reason: Z. As Built Submitted Check: Lot location, dimensions of system, location in regard to percolation tests, depth of system, water table ZZ.-__'Distance to Wetland Areas, Drains, Street & House, Drainage Easement and Wells. Tater Line Location No PVC Pipe 55. Septic Tank - Tees Cem t-, en P'1pe to Tank-Joints on both side of Tank. 6. Distribution Box - No cracks in box or cover, all lines flow equally from box. /7/Leach Fields - Dimensions, Stone Depths, Capped ends, Clean double-*„,ashed stone Leach Pits - Dimensions, Depth of Stone, Splash pad tees, Cement-pipe to tank- joints on both sides of tank, Clean double-i,ashed stone 9. No Garbage Disposals Final Grading 4fparricading of sub-surface system cp 0L_ '-4w � c r O` 40RTN 1,, - I .o r 'O Town of North Andover HEALTH DEPARTMENT ,SSACNUSft CHECK#: 16-/8(1 DATE: LOCATION: H/O NAME: �ycLr CONTRACTOR NAME: r� Type of Permit or License: (Check box) • Animal $ ❑ Body Art Establishment $ ❑ Body Art Practitioner $ ❑ Dumpster $ ❑ Food Service-Type: $ ❑ Funeral Directors $ ❑ Massage Establishment $ ❑ Massage Practice $ ❑ Offal(Septic)Hauler $ ❑ Recreational Camp $ ❑ Sun tanning $ ❑ Swimming Pool $ ❑ Tobacco $ ❑ Trash/Solid Waste Hauler $ /Ate- 0—__Well Construction $ SEPTIC Systems: ❑ Septic-Soil Testing $ ❑ Septic-Design Approval $ ❑ Septic Disposal Works Construction(DWC) $ ❑ Septic Disposal Works Installers(DWI) $ ❑ Title 5 Inspector $ ❑ Title 5 Report $ ❑ Other:(Indicate) $ r 3 Health Agent Initials White-Applicant Yellow-Health Pink-Treasurer CHARLES M.ROLLINS CO.,INC. Town of North Andover . ' 10/3/2007 15186 Well Permit: 66 Lacey St.-Craig Robinson 135.00 /o di' ��vr� 10 e Cash- Georgetown Sa Well Permit: 66 Lacey St.-Craig Robinson 135.00 NUMBER i NORTH COMMONWEALTH OF MASSACHUSETTS BHP-2007-0274 o?oT�•.. - ,,hoop FEE ` � n North Andover $135.00 • Board of Health SA US LACY STREET REALTY TRUST& Y K&J S WANG, TRS - - - NAME 66 LACY STREET ADDRESS IS HEREBY GRANTED A PERMIT Well Construction CHARLES M. ROLLINS CO. , INC. This permit is granted in conformity with the Statutes and ordinances relating thereto,and expires---------- January.05,2008 - ------ unless sooner suspended or revoked. October 05,2007 Board of -------------- - Health TOWN OF NORTH ANDOVER �°•�� Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 1600 OSGOOD STREET; BUILDING 20; SUITE 2-36 NORTH ANDOVER, MASSACHUSETTS 01845 ` Susan Y.Sawyer,REHS/RS 978.688.9540-Phone 'l .`{"5— Public Health Director 978.688.8476-FAX �✓ healthdept@townofnorthandover.com www.townofnorthandover.com Well and/or Pump Application (Please print) DATE: (fL?t 7 , ZaQ LOCATION to Drill Well or install a pump: 6 rr-,, Sg Licensed Well Contractor Name and Company Name: (2 kA QLeS VA, Ro"t,j S �O SNC• L--)-R Qe ag- "• I-&Dm�ot2.D A Contact Phone Numbers: q-?N_ ROQ-? _ Z -3 Z,® Cl¢ k _ a, ., 's 7 S� 6 S S^7 CA-0,l& A<3 P,t tJSO") Homeowner:/� .^Y� N Address: 66 �-`� &'{ Ste. . F1�O,i�2� Contact Phone Numbers: I-?P— ( ?�- ` ;1-( ,3 WELLS(to be completed at time of pump test) Type of well: ��QoC Use: pNN�P S t Diameter of well: \4 Size of Casing: b Depth of bedrock: Depth of casing into bedrock: Seal been tested? Yes( ) No( ) Date of test: Depth of well: Water-bearing rock: Depth of water: Delivers: GPM for: (how long) Drawdown: feet after pumping: hours at: GPM Date of Completion: � Signature ofdVell Contractor PUMPS(To be filled in before installation) Name&size of Pump: Type: Size of Tank: Pump delivers: GPM Pipe used in well: Cast Iron_ Galvanized Plastic Sleeve used to protect pipe? Yes No Type of well seal: Date: Signature of Pump Installer Date water analysis report submitted to Health Department: Plumbing Wiring Inspector Hea a art;nc t resentative C:\DOCUME-1\bcunan\LOCALS-1\Temp\Well Application.doc Town of North Andover RE: Applications for a permit to drill a well: Before a permit can be issued, you must have your contractor submit the following: 1. Submit to the Health Department a site plan showing the house and or lot footprint 2. Indicate any wetlands within 200 feet of the proposed location for the well 3. Indicate the well location 4. 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This is a mortgage .loan; inp. f �• for mortgage purposes only ► \ / �v9 LOCATION NORTH ANDOVER ver City or Town DATE March 10,-2003 S T , Certification is hereby made to GMAC MORTGAGE CORPORATI. that the existing structures showion. situated on the lot designate"in 'do setback requirements of the aaplicabl . of the municipality when constructed; from violation enforcement action un. Chapter 40A, Section 7. :1c This inspection was prepared in acco.: technical standards for Mortgage Loa w adopted by the Commonwealth of Massac \.\ by (v 9 ere Lan urveyor LA 9 ,fib / I DEED AND PLAN REFERENCE] ESSEX NORTH DISTRICT REGI tss li;3b Lc .q Deed Book 471;8Page Plan Book planIs / J(f, S I iYf i Certification is hereby made t this plan IS eNOTat located withiArea as delineated on the map community No. 1500980009C Effective Date;June 2. 1293 i By the U.S. Department of Housing 6 y, Federal Insurance Administration. GENERAL NOTES A confirmatory survey is advised whe �� (H OF.rgs ; shown to be sJtuated at ! foot or le \ y�FYi sq^ f lines or required setback lines or,. f encroachments are noted. CertJfJcat! basis of my knowledge,information an NY TEN i No.26099 e � CON \ -'� - � • � .- N� MORTGAGE SURVEY��s -rte c--N at iA i 126A PLEASANT VALLEY ST. -SUITE \ i ►� � �� ) TEL. (978) 975-2700 FACSI i � MORTGAGE INSPECTSO This is a mortgage .loaning. / I for mortgage purposes only LOCATION NORTH ANDOVER o City or Town DATE March 10, 2003 S * Certification is hereby made to GMAC MORTGAGE CORPORATI, that the existing structures shown an situated on the lot designate"In;co setback requirements of the appplicabl . f of the municipality when constructed; �1 , �7' , V "• from violation enforcement action and Chapter 40A, Section 7. 4c This insppection was prepared in acco technical atandard9 forpMortgage Lo ,a adoptad by the Commonwealth of Massae y b y g ere Gan urveyor :, U Iz O l S I b SN, PI DEED AND PLAN REFERENCE' / ` 6 ESSEX NORTH DISTRICT REGI Deed Book 479;8 Page Plan Book PlanJaS Certification is hereby made t Area asadelineatedoontthewmapi community No. 2500980009C �\� I Effective Date:J ne 2. 1993 By the U.S. Department of Housing 6 ' yy Federal Insurance Administration. ( GENERAL NOl ES ' A confirmatory survey is advised Nhe OF 9'ssq I linees or be uiredtsetback foot or rare I encroachments are Hated. Certll�icaSTEN tt. JEAN Y. basis of my knoNJedge,information an NY2W9 y I No.26099 Alli p�� e I MORTGAGE SURVEY CON �fk S�'f�e hal 1 NAL to I �> S 126A PLEASANT VALLEY ST. —SUITE TEL. (978) 975-2700 FACSI II ! i TOWN OF NORTH ANDOVER Building Department APPLICATION FOR PLAN EXAMINATION The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Date Received Permit NO-"-- Roofing, O:!Roofing, Siding, Interior Rehabilitation Permits Date issued: AVIP®RT�7C:A licant must com Tete aIl items on this age ❑ Building Permit Application LOCATION 66 Lacy Street , North Andover , MA 01845 ❑ Workers Comp Affidavit Print ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses PROPERTY OWNER C r a i g Robinson ❑ Copy of Contract Print , ❑ Floor Plan Or Proposed Interior Work MAP NO: PARCEL: ZONING DISTRYCT:R .1 M hine hop Village yes n ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential Addition Of DeCkS ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: 11 Commercial ❑ Building Permit Application " t ki Assessory Bldg s h a ❑ Repair, replacement P 11 Others: ❑ Certified Surveyed Plot Plan ❑Other ❑ Workers Comp Affidavit ❑Demolition i y:'= e11� '; '� ,+ f ;ljFilooclplam, (7iWetlaricls� *;�' atershecliDistrict' -; ❑ Septic~ (]w - , ° ? i {�i ❑ Photo Copy of H.I.C. And C.S.L. Licenses tx n , - ❑ Copy Of Contract DESCRIPTION OF WORK TO BE PERFORMED: ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (if Applicable) ❑ Mass check Energy Compliance Report (if Applicable) install a J[1 X 161 Garden / utility -Shed on property - • Engineering Affidavits for Engineered products VOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Identification Please Type or Print Clearly) OWNER: Name: Phond: 978-836-7554 Neter Construction (Single and. Two Family) Address: 66 Lacy ct rept - North AnAnirPr'. MA 01845 ❑ Building Permit Application CONTRACTOR Name: Reeds Ferry , Inc . Phone: ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses Address: 3 Industrial Park Drive , Hudson . NH 03051 ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to include Sprinkler Plan And supervisor's Construction License: a 6 a 3 4 Exp. Date: 5/12/12 Hydraulic Calculations (if Applicable) p. Home Improvement License: 1 1 9 9 0 3 Ex Date: 9/17/11 ❑ Copy of Contract ❑ Mass check Energy Compliance Report ARCHITECT/ENGINEER N/A Phone: ❑ Engineering Affidavits for Engineered products :)TE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Address: Reg. N°• FEE SCHEDULE:BULDING PERMIT-$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. III cases if a valiance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals L the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. one copy and proof of recording 'Petal Project Cost: FEE: 3t be submitted with the building application Receipt NO.: Check No.: Doc: Doc.Building Permit Revised 2008mi NOTE: Persons contracting* vntYacting with unYe��(j/J��(ateYedcontlacto�s do not have access to the guaranty fund .Q.�' — •4 _ :.L V' nafu�eo :c ..- , atue:of A`enf/Owner; f``ontractor Sign -- ---- - _ --- ------== . _gs-- Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Dimension Public Sewer ❑ Tanning/Massage/BodyArt ❑ Swimming Pools ❑ Number of Stories: Total square feet of floor area, based on Exterior dimensions.______ Well �❑ Tobacco Sales ❑ FoodPackaging/Sales ❑ Totai land area, sq, ft.: Private(septic tank,etc. ;O Permanent Dumpster on Site ❑ ELECTRICAL: Movement of Meter location, mast or service drop requires approval of THE FOLLOWING SECTIONS FOR OFFICE USE ONLY Electrical Inspector Yes No INTERDEPARTMENTAL SIGN OFF - U FORM DANGER ZONE LITERATURE: Yes No DATE REJECTED DATE APPROVED MGL Chapter 166 section 21A—F and G min.$100-$1000 fine PLANNING DEVELOPMENT ❑ ❑ NOTES and DATA— For department use COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Sinature COMMENTS 5�� r �� %1 AL Zoning Board of Appeals:Variance, Petition No: Zoning Decisionlreceipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer Connection/Signature Date Driveway Permit 0 Notified for pickup - Date DPW Town Engineer: Signature. Located 384 Osgood Street FIRE DEPARTMENT -Temp Dumpster on site yes no Doc:.Building Permit Revised 2008 Located at 124 Main Street Fire Department signature/date COMMENTS