32C-090 (3) of Northampto
n
t° SI
~saachusetts
294AR 1 OF BUILDING INSPECTIONS
ctr`'F 212 '$treet • Municipal Building
�, S »..•*14�
� Northampton, MA 01060 �1
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: l i'l r1��-On�P Y' n`i.Lt�R) � 17�4Gla io f-A yn '�✓ le-tt&7L
Address: 3A 4111 SU N Ktle• Telephone: Y/2j 37 y -Clog)
2. Owner of Property: 56t "Nip
Address: Telephone:
3. Status of Applicant: ✓Owner Contractor
4. Type or Brand of Stove: /rot U l S t—e Y e ry
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.
DATE: APPLICANT'S SIGNATURE
TDATE: 74b HOMEOWNER'S SIGNATURE
APPROVED
DATE: BUILDING OFFICIAL
31 WILSON AVE BP-2015-0001
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 32C-090 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-2015-0001
Project# JS-2015-000002
Est. Cost:
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: Homeowner as Contractor
Lot Size(sq. ft.): 13764.96 Owner: AQUADRO FAMILY TRUST
Zoning. URC(100) Applicant: AQUADRO FAMILY TRUST
AT. 31 WILSON AVE
Applicant Address: Phone: Insurance:
33 WILSON AVE
NORTHAMPTONMA01060 ISSUED ON:71112014 0:00:00
TO PERFORM THE FOLLOWING WORK.-INSTALL TRAVIS LEYDEN 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 7/1/2014 0:00:00 $25.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner