05-038 1
�t4 of Northampton
Massachusetts
JAN 14 2015 ,'' w
Es.
NT OF BUILDING INSPECTIONS
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Me.'n Street • Municipal Building's
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ectnc F uml �q&C.. ._Jections Northampton, 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
Permit Fee: $25.00 Check # /*//S
/� / (PLEASE,�T/YPE O/R�PRINT\ALL INFORMATION ^J
1. Name of Applicant: /`1/7 19 /\tLJV ✓ /
Address: J2�7�-� i� Telephone: � � 61
2. Owner of Property: 14 A 61 e f' (J tN) A—
Address: /LP/�'1/�'�' i � Zf''c� Telephone:
3. Status of Applicant:_Owner -Contractor
4. Type or Brand of Stove: J/,j j C Z,1'1 LiYyt.�2
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: � %
591 KENNEDY RD BP-2015-0724
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 05-038 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.14 A,
Category: woodstove BUILDING PERMIT
Permit# BP-2015-0724
Project# JS-2015-001409
Est. Cost:
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: Homeowner as Contractor
Lot Size(sq. ft.): 80019.72 Owner: DWYER WILLIAM H&MAUREEN
zoning: RR(100)/WSP(100)/ Applicant: DWYER WILLIAM H & MAUREEN
AT. 591 KENNEDY RD
Applicant Address: Phone: Insurance:
PO BOX 411
LEEDSMA01053 ISSUED ON.111412015 0:00:00
TO PERFORM THE FOLLOWING WORK.-INSTALL VERMONT 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 1/14/2015 0:00:00 $25.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner