32-011 (3) City of Northampton
`5 1
Massachusetts
`�- DEPARTMENT OF BUILDING INSPECTIONS x
212 Main Street • Municipal Building
Northampton, MA 01060
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#
9 PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: 3,c1"`�
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Address: i f i S Q Telephone ±/ - 3 12- 3
2. Owner ofProperty:_sR� `��✓ l� C c
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Address: / 4 `'' Telephone:
3. Status of Applicant: Lll;Ow Contractor
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4. Type or Brand of Stove: Lvooj 6 �',17��
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
6. Certification: I hereby certify that the information contained herein is true and accurate to the best
of my knowledge. ✓�,, /?
I C
TE: 3� APPLICANT'S SIGNATURE 2
DATE: HOMEOWNER'S SIGNATURE
APPROVED
DATE: BUILDING OFFICIAL
141 FAIR ST BP-2015-0508
GIs#: COMMONWEALTH OF MASSACHUSETTS
Ma :Block: 32-011 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-2015-0508
Project# JS-2015-000957
Est. Cost:
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: Homeowner as Contractor
Lot Size(sq. ft.): 41 1206.40 Owner: CARANGELO SAUL&LAUREL
Zoning: Applicant. CARANGELO SAUL & LAUREL
AT. 141 FAIR ST
Applicant Address: Phone: Insurance:
141 FAIR ST EXT (413) 312-0309 Q
NORTHAMPTON MAO 1060 ISSUED ON:1013012014 0:00:00
TO PERFORM THE FOLLOWING WORK.-INSTALL 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 10/30/2014 0:00:00 $25.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner