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37-046
:, City of Northampton�Q 4 i--)1 Sly -�, s j Massachusetts :4"'. °fit{e azi f DEPAR OF BUILDING INSPECTIONS ,g W j ectnc {-, 212 in Street • Municipal Building ,fir , N , r' Northampton, MA 01060 3E,1-„),'A ._.:/ions 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 # 3 / 5 {� PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: KNII'�. AkcoY ,�8- Address: /88 �cX111 �t., Moretti, M1� Telephone: iii 3 -yZ3 ` ?Z 9 2. Owner of Property: Ill i� Atotal t A. //�� Address: I�(6 Ruc-1: `� IA , Q� f re t u M1 - Telephone: `7 j 3 9 z3 J Bi Z'Li 3. Status of Applicant: )( Owner Contractor 4. Type or Brand of Stove: \/b e..1 r(.7,,A 3 5-11 © f,t1 k ${-oil Z 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. 7 r, DATE: ii/Z0/ i 3 APPLICANT'S SIGNATURE dikilirk--' DATE: i r/Lc)/ 1, HOMEOWNER'S SIGNATURE Itclik 0261^j------- APPROVED DATE: BUILDING OFFICIAL 188 ROCKY HILL RD BP-2014-0641 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 37-046 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-2014-0641 Project# JS-2014-001088 Est. Cost: Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: Homeowner as Contractor Lot Size(sq. ft.): 43560.00 Owner: ALAMED KYLE Zoning: Applicant: ALAMED KYLE AT: 188 ROCKY HILL RD Applicant Address: Phone: Insurance: 188 ROCKY HILL RD (413) 923-8724 () FLORENCEMA01062 ISSUED ON:11/21/2013 0:00:00 TO PERFORM THE FOLLOWING WORK:INSTALL VOGELZANG 5770 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 11/21/2013 0:00:00 $25.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner