17C-311 (2) \v,7-ktr\y of Northampton
`' t �1 Massachusetts ' ,t'S/�,,.
[ 5 2013 ` _: _,
I€�t.l :f sEP Dom' �� NT OF BUILDING INSPECTIONS :'
� t 21+ Man Street • Municipal Building i.%,P,s7,. -45'.'
Electric,Plumbing&Gas Inspections
Northampton, MA 01060 E ° C
Nor hampton,MA 010E0
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 # MI PLE ASE TYPE OR PRINT ALL INFORMATION
PROPERTY ADDRESS 3 V Hill(re s 1 D,, -C/o
L ✓_I C e
1. Name of Applicant: M +(V1 f Sti6(1 1r U
Address: 3 6 t'l t /i /p S+ 0 r Telephone: 3 Y-7 u- l F J
2. Owner of Property: N o r `c 3 1-1 a-pI ,17)
Address: 31, t 'I t c (64- Dr • Telephone: 3 K 7 t q K 75
3. Status of Applicant: Owners Contractor , � � ,,
4. Type or Brand of Stove: C�ti Ili vl de 7 i0e_it�-
Contractor's Name:
Contractor's Address:
Contractor's Phone:
Construction Supervisor's License Number: Expiration Date:
Home Improvement Contractor Registration Number. Expiration Date:
All Applicants must compete a W5rkers 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: 9 APPLICANT'S SIGNATURE iti ate.:
z
DATE: 1 5 //2 HOMEOWNER'S SIGNATURE � ......7
APPROVED
DATE: BUILDING OFFICIAL
36 HILLCREST DR BP-2014-0276
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 17C-311 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-2014-0276
Project# JS-2014-000472
Est. Cost:
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: Homeowner as Contractor
Lot Size(sq. ft.): 25613.28 Owner: MARTIN RICHARD C TRUSTEE C/O NETANIA SHAPIRO
Zoning:URA(100)/ Applicant: MARTIN RICHARD C TRUSTEE C/O NETANIA SHAPIRO
AT: 36 HILLCREST DR
Applicant Address: Phone: Insurance:
36 HILLCREST DR
FLORENCEMA01062 ISSUED ON:9/6/2013 0:00:00
TO PERFORM THE FOLLOWING WORK:INSTALL ENGLANDER PELLET 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 9/6/2013 0:00:00 $25.00
212 Main Street,Phone(413) 587-1240,Fax: (413) 587-1272
Louis Hasbrouck—Building Commissioner