22B-013 r_ City of Northampton
* Massachusetts
x a. DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street • Municipal Building
Northampton, MA 01060 A W,...
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 #
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant:
Address: S lt_; ��. ..i r2�c2 .^ Ifs Telephone: ` t �.d L-2.Z 2.�
2. Owner of Property:
Address: Telephone:
3. Status of Applicant: �Owner Contractor
4. Type or Brand of Stove:
Contractor's Name: lei - �cilzc'(i� c ��-ic_rc �
Contractor's Address:
Contractor's Phone:
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: �, ; r4 APPLICANT'SSIGNATURE --
DATE: HOMEOWNER'S SIGNATURE
APPROVED
DATE: BUILDING OFFICIAL
45 MEADOW ST BP-2014-0832
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 22B-013 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Buildinq DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: woodstove BUILDING PERMIT
Permit# BP-2014-0832
Project# JS-2014-001440
Est. Cost:
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: Homeowner as Contractor
Lot Size(sq ft.): 8712.00 Owner: MARVELLI CHRISTOPHER
Zoning: URB(76)/URA(24)/WP(15)/ Applicant: MARVELLI CHRISTOPHER
AT. 45 MEADOW ST
Applicant Address: Phone: Insurance:
45 MEADOW ST (413) 587-9284
FLORENCEMA01062 ISSUED ON:1/28/2014 0:00:00
TO PERFORM THE FOLLOWING WORK.INSTALL JOTUL 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 1/28/2014 0:00:00 $25.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner