31A-309 (6) City of Northampton
Massachusetts ,.
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y ff DE NT OF BUILDING INSPECTIONS ^
f AUG 2 8 2014 2 in Street • Municipal Building .,
Northampton, MA 01060 SsNy N
Electric, Plumbing&Gas Inspections
North_Mptcn MA 011060
SINGLE OR TWO FAMILY SOLID FUEL APPLIANCE PERMIT APPLICATION
FOR WOOD, COAL, PELLET, CORN, STRAW OR SIMILAR STOVES,, OR FIREPLACE INSERTS
Permit Fee: $25.00 Check # 0(e
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: MEt'1ftMMrp A1Mftl,FVS MACK
Address: 9,5 V ERNo N ST. Telephone: 91: 1-6:7— q�5 2-6
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2. Owner of Property:
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Address: Telephone:
3. Status of Applicant: V Owner Contractor
4. Type or Brand of Stove: PL.SftyftNT "E:A-K -)A I) 200 5q. f{. OPT, Cet'h ed WOOA-
- ®uthi►\g 5-bJe w/ 5towet' , N1ediuvr
If applicant is not the homeowner:
Construction Supervisor's License Number Expiration Date
Home Improvement Contractor Registration Number Expiration Date
All Applicants must complete a Workers Compensation Insurance Affidavit before we can issue a permit
5. Certification: I hereby certify that the information contained herein is true and accurate to the best
of my knowledge./
DATE: 'R/48/ IL} APPLICANT'S SIGNATURE
DATE: S/Zg�l4 HOMEOWNER'S SIGNATURE��
APPROVED
DATE: BUILDING OFFICIAL
93 VERNON ST BP-2015-0231
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:3 1 A-309 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: woodstove BUILDING PERMIT
Permit# BP-2015-0231
Project# JS-2015-000433
Est. Cost:
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: Homeowner as Contractor
Lot Size(sq. ft.): 19602.00 Owner: MACK MEHAMMED
Zoning: URA(100)/ Applicant: MACK M E HAM M E D
AT. 93 VERNON ST
Applicant Address: Phone: Insurance:
93 VERNON ST (917) 767-7526 O
NORTHAMPTONMA01060 ISSUED ON:812912014 0:00:00
TO PERFORM THE FOLLOWING WORK.INSTALL PLEASANT HEARTH WOOD STOVE
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector
Underground: Service: Meter:
Footings:
Rough: Rough: House# Foundation:
Driveway Final:
Final: Final:
Rough Frame:
Gas: Fire Department Fireplace/Chimney:
Rough: Oil: Insulation:
Final: Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupancy signature:
FeeType: Date Paid: Amount:
Building 8/29/2014 0:00:00 $25.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner