24C-164 (2) City of Northampton
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4` � EPAR NT OF BUILDING INSPECTIONS
NOV {{}}��212 Street • Municipal Building
` orthampton, MA 01060
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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
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Permit Fee: $25.00 Check #
PLEASE TYPE OR PRINT ALL INFORMATION
PROPERTY ADDRESS 1'0 k I rU cz.
1. Name of Applicant: j A LL • V v
Address: 66) f' 'q N iD1( Telephone: -T — Z'VCJ
2. Owner of Property: `1'1 I
Address: J 4-i'l`? -f Telephone: —7 7C11-1,-*//
3. Status of Applicant: Owner Contractor
4. Type or Brand of Stove: Kc v1A c 1.0 ` C A3-4- 1 vt)
Contractor's Name: IV Ga
Contractor's Address: N ( I'
Contractor's Phone: N/ 4-
Construction Supervisor's License Number: NI Expiration Date:
Home Improvement Contractor Registration Number: 109 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.
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DATE: I�GV• I 2--,)-03 APPLICANT'S SIGNATURE C'
DATE: HOMEOWNER'S SIGNATURE
APPROVED
DATE: BUILDING OFFICIAL
66 FRANKLIN ST BP-2014-0593
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:24C- 164 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-2014-0593
Project# JS-2014-000994
Est.Cost:
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: Homeowner as Contractor
Lot Size(sq.ft.): 16944.84 Owner: MINER DONALD W&BARBARA B
Zoning:URB(100)/ Applicant: MINER DONALD W & BARBARA B
AT: 66 FRANKLIN ST
Applicant Address: Phone: Insurance:
66 FRANKLIN ST (413) 584-1200 0
NORTHAMPTONMA01060 ISSUED ON:11/12/2013 0:00:00
TO PERFORM THE FOLLOWING WORK:INSTALL VERMONT CASTINGS WOODSTOVE
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 11/12/2013 0:00:00 $25.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner