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001C FILLMORE ROAD - BPA-15-1401 A w �JS abs The Commonwealth of Massachusetts RECE VEO e Board of Building Regulations and Standards ''NSPECTION L $�AVL�qF� Massachusetts State Building Code, 780 CMR Revised Mar 2011 T Building Permit Application To Construct,Repair,Renovate Or 2 1 A CP 2 b n One-or Two-Family Dwelling `✓ This Section For Official Use Only Building Permit Number: Date Applie U ' Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Pro Addrress �.,^ &n � ©I�l� 1.2 Assessors Map&Parcel Numbers 1 tthi�s an accepted street?•yyeets�_ no_ Map Number Parcel Number Lla Is 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Zone: _ Outside Flood Zone? Municipal ❑ On site disposal system ❑ Public Private Check if yes[] SECTION 2: PROPERTY OWNERSHIP' 2,];Owner'ofRe�� Cl_ Ipm �. ©j01�� Name(Prin City,State,ZIP No.and Street Telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK'(check all that apply) New Construction❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) ❑ Alteration(s) ❑ Addition ❑ Demolition ❑ Accessory Bldg. ❑ Number of Units_ Other ❑ Specify: Brief Description of Proposed Work: SECTION 4: ESTIMATED CONSTRUCTION COSTS Estimated Costs: Official Use Only Item Labor and Materials 1. Building Permit Fee:$ Indicate how fee is determined: 1.Building $ S15 �3/ ❑Standard City/Town Application Fee 2. Electrical $ ❑Total Project Cost'(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire $ Total All Fees:$ Suppression) Check No. Check Amount: Cash Amount: 6.Total Project Cost: $ j/S 3� 13Paid in Full ❑Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) `DS�� o? -13 —Rnu4t kr occ% License Number Expimoon Date Name of CSL Holder�^ List CSL Type(see below) e- ,^, Type Description No.and Street I U Unrestricted 2 Family s u el ing cu.ft. R Restricted 1&2 Famil Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding / SF Solid Fuel Burning Appliances hisulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(RIC) r / 7P3 O HIC Registration Number Expiration Date MC impany�Name or HIC R trName and Street ��d-� q�•�77•SS�� Email address arU; , _t Ci /Town,State,ZIP Telephone 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 Issuance of the building permit. Signed Affidavit Attached? Yes .......... No ........... ❑ SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTORAPPLIESFOR BUILDING PERMIT _I _ LIF� � 1,as Owner of the subject property,hereby authorize t✓I to act on my behalf,in all matters relativep work authorized by this building permit application. hyail Print O er's Name(Elea a[u Date SECTION 7b:OWNEW OR AUTHORIZED AGENT DECLARATION By entering my name below,1 hereby attest under the pains and penalties of perjury that all of the information contained in this application is true and accurate tote best of my knowledge and understanding. 0 -f 1111711r Print Owner's or uthonzed Agent's Name(Electronic Srgoature) Date NOTES: [Total 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 can be found at www mass eov/oca Information on the Construction Supervisor License can be found at nvw_mass oov/dps When substantial work is planned,provide the information below: floor area(sq.ft.) (including garage,finished basement/attics,decks or porch) area(sq.ft.) Habitable room count Gross living Number fireplaces - Number of bedrooms ths Number of bathrooms Number of decks/half1bporches Number of decks/po Type of heating system rches Enclosed Type of cooling system Open 3. `"Total Project Square Footage"may be substituted for"Total Project Cos[" WARM TRADITIONS STOVE SHOPPE A Division of AQUA TERRA PROPERTYMANAGEMENT,INC. Construction Supervisor Contractors License #CSFA-105711 Robert Raucci IM MassaehusattS - C)eo erg C'unm,t¢tion Super isor ! .i _ —cense CSFA 105711 ROBERT G RAUQCI 123 NORTHBROADWAY HAVERHILL MA 01832 J..�•..�� 02113/2016 Home Improvement Contractors License #170349 Aqua Terra Property Management, Inc. �e�.rirrunv.urvn/�-r�(��r,rnr�adella `. Office of Consumer Affairs&Business Regulation _WHOME IMPROVEMENT CONTRACTOR t j{Registration 170349 Type: Expiration:. 10/12/2017 Corporation AQUA TERRA PROPERTY MANAGEMENT INC. ROBERT RAUCCI1-- 110 NEWBURY ST 11C;:_ DANVERS, MA 01923 - Undersecretary 110 Newbury Street #11C P.O.Box 2081 Danvers,MA 01923 978-777-5562 Tue Nov 17 15:20 : 07 2015 From: GENERAL_DELIVERY,MB To: 9197- '`.2389f 2 (IAMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 1 11/17/2015 THIS CERTIFICATI: IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOZES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BE-RNEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE.OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If th4 certificate holder Is an ADDITIONAL INSURED, the pollcyiesj 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 NpAME Sennott Insurance INR Nvo,Exl1. 16 South Alain Streete-MAL ADDRESS rCErr ----------'--- P. 0. Box 457 ------------- TqEsPleld MA 01983 _ INSURER(S)AFFORDING COVERA3E INSURED INSURFRAAcadia Insurance INSURERB:1)niOn Insurance Co. Aqua Terra Praperty Management, Inc. 1 INSURER C. DBA Warm Traditions Stove Shoppe wsuRERo. P 0 Bax 2081 INSURER E' Danvers MSA 01923 wsURERF: ----------------.,-- -- --- COVERAGES CERT!FICA'TE NUMBER:15-16 renals REVISION NUMBER: THIS IS TO CERTIF(THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE iNELRED NAMED A30VE FOR THE POLICY PERIOD INDICATED. NOTWTOiSTANDING ANY REQUIREMENT, TERM OR CONDIT'ON OF ANY CONTRACT OR OTHER, DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY 1JE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUS'.ONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INLS SRI --- --_ -----'AODCSUBRI Y EF POLICF-I-P61'ICY EXP - -- - - _ - -_ TY E QF INSURANCE I�S$�, POLICY NUM3ER I jMWDCIYr1Y)i1MMIDDIYYIY LIMTIT III 41 i 000,000 I glrrn A-.I Au "LNERk[ LAEI�TY Gcaclr.�i E E c�a ,_."I 1D0,000 L O M D (Alf C E, J0: a 5,COO A CLAIMS S'1FDE g' or:UR _ �S F Ntl-&'OIInnJ.v 1,000,000 2,000,000 „ 2,000,000 —r AUTOMOBILE LIAB,L'V 33389-15 d/14/i015 4/14/2015 tOtnSIN9SN(Lc-.n TF 1,000,000 rl�U:)T$.. B , v.LOWNE 1 r, b0 I IINJLFYIF c,d nU'I X SCHEDULE < 7C£ Pr r RT` iAI4fi(,E g r RFJ AUTGg i i I P Tae_ RRITOS UMBRELLA LAR LAit Ig1 lF pUA0335764-15 -- !04/1412015 4/14/201oi PC .CUcElv-E-__ —1,000,0_00 EXCESS UAB L Is. .nN.�.EI LFr�v-��Tt I.- 1,000,000 A h �R F l CN S. --.—.— A 1WCERB COhfN' PEA'ION —r- A0333S99-15 4/14!2015�4i 14/2015 -T° U :O,H I5'* I RH -- ANDEMPLOYERSLICBILITY YINI ANr PRGPRIETO�PIRTNEPIE,4CUTIJE(-^1 P L EA 211 n ur1 NT 500,000 SMAntletoN in NH) L ICEG1n1ENE _'CLUD�4 N/A! I- ---I 6A-_ EF E1._LOYE- a 500,000 ue1 -I- -s FOU(: LIMIT Is 500,000 ,v � I LE>. IP'OH:' OF EF ATIOLIS below _ I _ _ —L- 1— ------ '------ ---- -- DESCRIPTIQN OF OPERATI JNS(LOCATQNS I VEHICLES IAttech ACOR0101.Addldonui RemerkP SGhetlule,If mon space ie"qui.04) CERTIFICATE HOLDER CANCELLATION i_ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Cheryl Uva 1 Fitl.=rEl Road -- -- Salem, VUL 01970 AUTHOR2ED REPRESENTAI'iVE %> Peter SerrottfAAM ACORD 25(20091091 O 1888.2009 ACORD CORPORATION. Al: rights reserved. IN3025(ton?oe) fie ACORD nameand logo are registered marks of ACORD t The Commonwealth ofMassachuseats Department oflndustrialAccidents Office oflnvesidgations 600 Washington Street Boston,MA 02IIZ www.massgov/dla Workers' Compensation Insurance Affidavit:Bonders/Contractors/Bleddeians/Plumbers ncant Informationlease Print UFO flea—tec'rfa wee an�ac ement, lnt�• Name.(BusineWorgsnization/Individual): V,11 term t rad-4E 41S -2 Address: 110 TAb �9• 0• ('(.TJX CA6911 City/State/Zip: ravels, 1'`'Ier . 0(clol aJ Phone#: Are you an employer?Check the appropriate boa: Type of project(required): 10I am.a employer with4— 4. ❑I an a general contractor and I 6. ❑Now construction employees(full and/orpart-time).* have hired the sub-contractors 7 ❑Remodeling 2.❑ I am a sole proprietor or partner- listed on the attached sheet i ship and have no employees These subcontractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance. 9. ❑Building addition [No workers'comp.insurance 5• ❑ We are a,corporation and its lo.❑Electrical repairs or additions required] officers have exercised their of exemption per MOL 11.[]plumbing repairs or additions 3.111 am a homeowner doing all work right of p myself.[No workers' comp. c.152,§1(4),and we have no 12.E]Roof repairs insurance required.]t employees.[No workers' 13.N Other�e It15'1t=Y11A ' comp.insurance requhrod.I "Any applicant that checks box#I mustalso fill out the section below showing their workers'compensetlon policy information. t Homeowners who submit this affidavit indicating they aro doing all work and then hire outside contractors must submit a new affidavit indicating such. IConmmars that check this box must attached an additional sheet showing the name Of the sub-contractors and their workers'comp.policy inforrna6011. I am an employer that is providing workers'compensation huurancefor my employees. Below is thepolky and job site infomrallon. Insurance Company Name*: Policy#or self-ins.Lie.#: U t✓�1- D 5;5!5!5 C)— I S Expiration nate 'f`I--/� �1 (�7 Job Site Address: city/State/Zip: 1 t ' Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required imtiei Section 25A of MOL 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 cerci der the eros penalties ofperpry that the Information provided above it true and correct Srp�tatum � � sy I C Date Fho e ' a7 —T7 opttel d use only, Do not write in this area,to be completed by city or towti'trfficlai Permit/License# City or Town: Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6,Other Phone#: Contact -- Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"..:ovary person in the service of another under any contract of hire, express or implied,oral or written." are An employer is defined as"an individual,partnership,association,corporation or other 1aga1 entity,or any two 0 in ofthe foregoing engaged in a joint enterprise,and including the legalropresontadves of a deceased employer,or the receiver ortrustee 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 be deemed to bedan welling Y�house or on the grounds or building appurtenant thereto shall not because of such employment MGL chapter 152,§25C(6)also states that"every State or local Ile aing 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 its political subdivisions,shall Additionally,MOL chapter 152,§25C(7)states Neither the commonwealth nor any p 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 cate(s)of necessary,supply sub-contraotor(s)name(s),address(es)and phone number(s)along with i h with n employees other than the insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP) 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 ibis affidavit maybe submitted to the Department of Industrial verage. Also be sure to sign and date the affidavit. The affidavit should Accidents for confirmation of insurance co be returned to the city or town that the application for the dingt or license is being requested,oo o�Department�t of industrial Accidents. Should you have any questions re $ardmg the law or if you arc required compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license mrmber on the r nate 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. it'onan applicant Please be aura to fill in the permittlicense number which will vused aineed my submit o affia relbrOnce number' 'a davit indicating current that must submit multiple permrt/license applications in any given year, policy information(if necessary)and under"Job Site Address!,o ee napplicantrbh�� write on locations��to(tha or town)."A copy of the affidavit that has been officially or licenses. Anew affidavit must be filled out each applicant as proof that a valid affidavit is on file for future permits year.Wham a home owner or citizen is obtaiaing a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. would like to thank you in advance for your cooperation and should you have any questions, The Office of Investigations please do not hesitate to give us a call Tha Department's address,telephone and fax number: , The Commonwealth of Massachusetts" Departroant of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel.# 617-727-4900 ext 406 or 1-877-MASSAFB Fax#617-727-7749 svised 5-26-05 Department of Code Enforcement Debris Disposal Affidavit In accordance with the provisions of GL,c. 40, sec.564,a condition Of permit it. _is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defingd by GL, c. I 11,sec. 150A. The debris will,or hes been disposed orat: lm_ r' ot+ 110 4et-ubur� SA-r- bo�vus, LOcali ` O of Facility :: Rrrl itlrs1f— r`- Q()Qq�erAen}— ou,0 4e,, bt ry St 'Paabodq, A46 019(FC —11 tqcq�n Location of action/jobsite (Street Address) Signsture of appiicanticontractor Date Aay person•plannuig non c,t,.r...•- a free COPY Dy cw,+us I"nis form satisfies atibasio reci=cmenYs 01 me stave� if ne . AI to any work on your residence.you may obtain. languageto protectho�ade to Homelegal advice IImprovementf before Ogren 6 eat 617-973-8787 or 1-888'283-3757 or on or¢website. Massachusetts Consum Consumer InformationHotlin Contractor Information Office of Consumer Affarrs aadBusmess Regulation's Conslmr HomeownerWormation Company Name tem home rM t Nmrw nQ di�Jt5��0�1 , Contractor/Salesperson/Owner Name bPl1� il�CLt Street Aess o notuse aPost Office Box address) .^ 'r'' yip Code Business Address(must (includeastrCtaddressfNve�I t,'•C" State �� IV�IX�IJv _T_ yipCodee City/Town l C ©T01" Citylfown Evening Phonc L) / •5S[v� Daytime Phom /1—) • /� II OO ilon & . Federal Employer ID or S.S. BuNvmbv lotion euro 9 G� Business Pa,mc]mPm n^cnt Cnm.m rMN=W /6 O /• �7L� f Mailing Address(It dlfl'erentfrom,above) C)rmw ecanirm tbntmostbeme ima*°"c'nc"t mnirnctarb& n ynlid ro6latwtion numb er es to do the following mw'o heftype,brand and grade of materials to be v'sed,use a'dition 1=bW(S%C:'"° aIX•) The Contractor agr leted,specify g (Descdbein de[ailthe workto � Qom-' used Start and Completion Schedule-The following schedule will 0mlits are required Prop cos beyondthe contractor's control arise x as the homeotvnex's agent:' be adheredto unless circumslnti -Required Permits-The following lmildin6'P contractedworlc andwillbescouredby'lidContracto . .its'will Date when contractor-Will begn (owners who secure their own per revisions of completed, excluded from the GuarantyD p Date When contractedworlcwillbe substantially 1VLGL chapter 142A.) Total ContractRriceandPs, :atsehed'nle 81andlaborspecified aboveforthetotalsumof: The.Comractor agrees to performthe overly fumishthe mater wing schedule: Payme�s v+illbe made�or�g t0'follo upon signing contract(notto exceed 113 of the total corltmot price or the cost of special order items,whichever is greater) P ,,n �� or n completion of $ �.�•by __ . • $ —by �_/� or upon completion of 's satisfaction) . upon completion of the contract, (Lay.'forbids demanding full payment contract is completed to both party $ $ to be paid for —�— mentmusthespecial The fed bMeen,the atMgte $--mbe pfdfor ordered bw`ore the contra'-'tedwork begins in oder s May tomeetthe.G=Pletion scliedvle.('Ra') - the contra. MentforInStUm egdtaut es xm Law requires that any deposit or down-payment required by NOTDS:(x)Including all finance chaal rg C ) the actual cost of any special equipment or wstommade mmen not exceedUie greater of (a)one-third of 1110 total cetitract letio or(h) which most be speoial ordered in advance to meet the completion schedule. ❑ nI terms o the W�frgntyraastc attacd f t e c ntrnet .t e t A io . ofluiro aLiout'�0 tl'act Td n _ n e rens nr nn bei _.r d.,.,.r ;�• .. *_ improvement t Contractor 0 Registration. oumay mr(lilr a out n o to 1buDirector at 10 PaxlcPlaza,Room 5170,Boston,MA D2116 or by calling 61?- -9787or 888-28 ge,or . subcontracto[s to be registbred vnth the Director ofHome Impr ee coin any information so that you can confirm coverage,or ask to registration by writing Does the conh'actor have insurance'?dt�t ntractox fox tits inam'an P a co of the Consumer sec a copy of a"proof of insliran. e I{aowyourrigh'tcandTesP°nsibilities. head'theImportantlnfomtationoatherevarseside ofthis form and get COPY Guide to the Home Improvement Contractor Law p provided you notify the telegram sent or by delivery,not later tbanmiflnight of the Xou may cancel this agreement if it has been signed at a place other thanthe coo�ad by s nod al lace of business, contractorin ng athis/hei roam office or branch office by ordinary mail p third business day following the signing of this agreement. See the attached notice of canceller on form for an explanation of this right. , CONTRA CT]F TBERE ARE ANY BLANK SPACES!11 DONOTSIGNT�S tothellommorner. Theothercopysholdd eptbytbaconhactor, V-10meowns res of the conhectmustba completed aad signed. One copy shoold Gro ^ J� Cor3tlactor's CSigna ture `r CB4.200 4Peltet insert Listing and Code ApProvets A. Appliance Certification E. BTU & EfFciency Specifications MODEL: 1200-I?Pellet Insert Emissions Rating: .9 grams/hr LABORATORY: OMNI Test Laboratories, Inc . `BTW Output: 14,400-40,000 l hr REPORT NO. 061-S-13-2 Heating Capacity: up to 2,500 sq.ft. depending •on climate zone TYPE: Solid Fuel Ro6m,Heater/P611et Fuel Hopper Capacity: 60-75 lbs Burning Type Insert STANDARD: ASTM E1509 951'ULC 5628.93, ULC' Fuel, Wood.Pellets-or Shelled Corn S610-M67, ULC'S6N Mg3 and ULC/ Shlpping;Wetght; 2 431b ORD-C1482-M1990 Doom Heater Pallet Fuel Burning Type and (UM) 84-HUD, •BTU output will vary,depending on the brand of fuel you Mobile Home Approved use in your appliance. Consult your Quadra=Fire dealer for best results. B. Mobile.Home Approved This appliance is approved for mobile home.installations WARNINGI Risk of Firel Hearth&'Home Technologies dis- when not installed in a sleeping room and when an outside claims any responsibility for, and the warmhfy and agency combustion air inlet is provided. The structural integrity of the listing'will be voided by the above actions. mobile home floor, ceiling,and walis;mustbe maintained.. DO NOT: The appliance must be properly grounded to thV frame of • install or operate damaged appliance- the mobile home and use.only 118ted'peiletVent,:Class"L"or . Modify appliance "PL"connector pipe. A Quadra-Fire Outside Air Kit must-be . Install.other than as instructed by Hearth & Home installed in a mobile home installation. Technoiagles, Note: This appliance Is also approved for'Installation Operate the appliance without fully assembling all Into a shop. components • Overfire j Install any. component not approved by Hearth & i Home Technologies C. Glass, Specifications • .Install parts or component's not Listed or approved. Improper installation, adjustment, a , service or lteration This appliance is equipped with 5mm ceramic glass. Replace maintenance can cause injury or property damage. glass only with 5mm ceramic glass. Please contact your For assistance or additional information,consult a qualified dealer for replacement glass. installer, service agency or yourdealer,.,,. NOTE: This 'installation must conform with local codes. In the absence of local codes you mu"st40mplywith the ASTM NOTE: Hearth&Home Technologies, manufacturer of E1509.95, ULC 5628.93, ULC 66 10-111187, ULC/ORD-C- this appliance, reserves the right alter its products, 1482-M1990, (UM) 84-MUD. their specifications and/or,price without-notice. D. Electrical Rating Quadra,Fire isa-registered tradertiark 115 VAC, 60 Hz, Start 4.1 Amps;Run 1.1 Amps of Hearth &Home Technologies. o..,o 'a' 7014-188 September 16, 2009 �Iwiii w A, v Width Width Height Height Depth Depth Weight BTU/Hr meaning Hopper EPA Certified e. Oursine Inside Clai Inside Inside On Delppth Ob91 gz Burn Rate Ca acit Emissions Efficient Fireplace atrepaow Fireplace F;replare nreomreInput' Capacity Itbe/nnua P Y' Y Imzl Ig/noun 7Wn.. 14,620 to 1,300- omn36-5/8" 32" 29-3/4" 23-7/8" 15" 13-1/8" 425 52,460 2,900 sq.(L 1.7-6.1 52 g86.5% 36-5/8" 32" 29-3/4" 23-7/8" 15" 13-1/8" 425 14,620 to 1,300- 17-52,460 2,900 sq.ft. Castile 32" 28" 25" 19" 13" 10" 260 12.900 to 700- 1.5-4 45 1.8 81.7% Insert 34,400 1,800 sq.ft. Classic Bay 28-1/2" 29-1/4" 25-1/2" 19-1/2" 13" 11" 243 17,200 to 1,000- 2.0-5.5 75 1.3 85.2% 12001 to 22" 47,300 2,600 sq.ft. Santa Fe 21-1/2" 28-7/B" 25-3/e" 23" 12-3/4" 8-5/8" p1G 12.900 to 700- 15-4 45 1.8 78.6% Insert 34,400 1,800 sq.ft. CLEARANCES Mt.Vernon AE ;K 4caseseser Insert e A - e'E _D—_DNWSAaM 1_0 MnMASONRY&ZEROCLEARANCE BUILT-IN INSTALLATION INSTALLATIONS r n /2- r Masonr 24" 16-1/2' 23-7/8" 34" • 3" 2" ]-1/2' 2-3/4' 3` 6'. 2C 24' 16-1/2" 23-7/8' 34" 6" 6" Mt.Vernon E2 ray —� Insert A ..__ \\ • A :, _, 1 e 11 a g C .... C 1 . .- .. \ _ E — omminnm ee oon MASONRY&ZERO CLEARANCE BUILT-IN INSTALLATION INSTALLATIONS Masonr 24" 1 r • iop.•em 6-/2 - 8" 34 Li;.ani237/ 34` 6. 12.. 0` 0" 6. 6" 3.. 2" 7-1/2' 2-3/4" 3.. 6" Castile Insert o iA WA B. ICI L t MASONRY&ZERO CLEARANCE INSTALLATIONS BUILT-IN INSTALLATION r Masonr 23-5/8' 17" 1 21-1/4'. r Y' 2` ZC 23-5/8' 17" 21-1/4" 28-1/8" 16" 12" 4-3/4" 10" 6" 6" Classic Bay 12001 © A c •sn.mneer p.mecoca 1 8 B �.r30en We an.ma,eno.,r-vz' E n E MASONRY&ZERO CLEARANCE BUILT-IN INSTALLATION losing rear shroual INSTALLATIONS • �:ar.em iovt�i r. i iov�enC ar. i`rop:am "2 asonr 22' 6- 12' 3" 6• e- .ea0.n 2-1/2" 3" 0' ZC 22' Santa Fe Max.Manel oepmnzsn. --1 Insert - A c o p 0 vt 8 B B. 1 c 'E I Cb® _ Frypee .Ardlee. MASONRY&ZERO CLEARANCE BUILT-IN INSTALLATION INSTALLATIONS • e 1 - cars" - rearvem p Masonr 24' 16" 23-1/L" 29-1/4" 6' 2 2-1/2" 2" 2-1/2" 3" ZC 24" 76" 23-1/4" 29-1/4" 'BTU/Hour Input calculated using premium wood pellets at8,600 BTU/Ib. BTU output wilt vary depending on type of fuel used,Fuel density and pellet shape will affect hopper capacity;2 See your focal DUadFa-Fire dealer for help in determining the product that best suits your heating needs based on climate and home efficiency. WARM TRADITIONS STOVE SHOPPE 110 Newbury St.(Rte I South) 3708 P.O.Box 2081 Danvers,MA 01923 978.777.5562 TO CherY.1 Uva........... ............ DATE........12-21-15 . ...... .................................. 1C Fl11115.9re Road .............. JOB NAME 978-882-1488 .-Salem.,.MA 0 19 17 01 ............................... JOB LOCATION......................................................................... ................................................................... TERMS Serial # 00707100607 r > 1....._.4/F Classic _Bay 1200 Insert All Black $3.,_018:00_....... ---l- S.t.an.da�.rd.....S.u.r..r.o.un.d with Bl4ck .Nickel Trim............... .... .................................................................... LessQ/F Coupon #GQT5ll3l-3S,6H--......................................................................................................................... 50.11-00 -4-B,11=07,30 Yl.00.r Pro t-ec,tcr, ........._2.29.. !GO Rear Shroi ................. ............$........._1.6.9..:..09......... I #$11..-.072.0......3_'.'.......to 421 Of.fs.et Adapt.er.................................. $............ ...2.5 S,S Liner-K it.............. 5,00.1 Blockoff Plate -75, !00 I Tube of Silicone ... ........... 18 !00 5 Bags of Pellets - N/C-: '.Vax on $4, 101 .00 $ 256.:31-..__ Installation Labor. $ .....8.0.0.,'0.0.......... .-Building Permit ....... -28 -'100 ............... -Deposit-11-18.=15 Check 41423 -$ 2001,'21 $4,985 ��.31 ......... ................ ......... ................................................................................................. ................. .................................... Thank You American Properties Team, Inc. /\ TO: 1C Fillmore Road FROM: Jennifer Pappas, Property Manager RE: Pellet Stove Installation DATE: November 16, 2015 **�:x*******�*sr**s��*x*r�r+*sx*a�***►xs**»**r******x*�*�a**a*s*m�t�**rra Please be advised that the Board of Trustees for Pickman Park has approved the installation of a pellet stove at the above referenced unit. This approval is contingent upon the existing flu being used. We also require that permits be pulled in advance (regardless of what your contractor may tell you), and then a copy of the final approved permit once completed must be sent to APT for the unit file as well. You will need to bring a copy of this letter to the Salem Building Department in order to receive your permit. Should you have any questions or require additional information, please feel free to call the APT Service Team at(781)932-9229. cc: Unit File 500 WEST CUMMINGS PARK-SURE 6050• WOBURN �MA •01801.781-932-9229 •FAX 781-9354289 >?IGCCi'�1,7, SELLrR: GPB REAL ES7"AfiL. HOLDINGS LLC, a Yla� chusetts limited liability company By; frontier Ho! irres laiL„ i(s rMa;aginm 1)ember 4� ',tdme; A3�asta;io51'arafst:r l ille.; F' E"dre"BUM,; f BUYER: 7 Multi-Staw, I oldingts,UC a Delaware limited liabiity co poll F Bv ,Nall1C: .. Ilike pf&m:I att'z z r .. _... .W' n 'Yh a—..w.e..m.:umuumK»......aAbrm.v'wrvxmwvemmvn x. :a w..•. w.... "— —u'_"w�.�.�.