24A-228 (2) � r
CE Ca (a, �.`1 : �i y of Northampton
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/� �' Massachusetts 4 - '�
;i ..; 0 212013 ,
I . TMENT OF BUILDING INSPECTIONS 9
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Cir :`f\01060 Northampton, MA 01060 .P h, 3��1`
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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 # 13 I+
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: / d
cant: \ 2-R 8a SJ er �
i
2 �
Address: 4P Pi/7'1-1m 2 lr Telephone: 4"/J-5-8'4 -3 3 g V
2. Owner of Property: Joa.-n fB" a-f, e ri(„ 4-7e..Q ✓I'ie (?)(1 Q et 4
Address: 7 ( P1 &ri hi J1,f- Telephone: 0'3-5-r6 33 y
3. Status of Applicant: y Ownerr Contractor
4. Type or Brand of Stove: H2,fat et r1 1" , eC-e--/`l Q- A,0')"pe Ik r /hsr 7
.Frey lQe--e---)
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.
_ f
DATE: /o// 7/13 APPLICANT'S SIGNATURE 0 `
DATE: HOMEOWNER'S SIGNATURE
APPROVED
DATE: BUILDING OFFICIAL
46 PILGRIM DR BP-2014-0492
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 24A-228 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-2014-0492
Project# JS-2014-000836
Est.Cost:
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: Homeowner as Contractor
Lot Size(sq. ft.): 29620.80 Owner: BARBERICH JOAN
Zoning:URA(100)/ Applicant: BARBERICH JOAN
AT: 46 PILGRIM DR
Applicant Address: Phone: Insurance:
46 PIILGRMI DR (413) 586-3344 Q
NORTHAMPTONMA01060 ISSUED ON:10/21/2013 0:00:00
TO PERFORM THE FOLLOWING WORK:INSTALL HARMAN ACCENTRA WOOD PELLET
INSERT
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 10/21/2013 0:00:00 $25.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner