37-068 City of Northampton
i Sys •:' S�ci
E
" L Massachusetts
DEPARTMENT OF BUILDING INSPECTIONS M
212 Main Street • Municipal Building
Northampton, MA 01060
NOV 2 3 201 J!
FAMILY SOLID FUEL APPLIANCE PERMIT APPLICATION
FOR WOOD,COAL, PELLET,CORN,STRAW OR SIMILAR STOVES,OR FIREPLACES
Check#
Please fill in all appropriate 1 formation
1. Name of Applicant :
Address: 2!U ' y Telephone: f�
2. Owner of Property : I 12Z 'y1_7 /JL�ole_ j
Address: (p ��� Z— Q�jSCl1 Telephoner_ -
3. Status of Applicant : Owner Contractor
4. Type or Brand of Stove :
5. Estimated Cost :
If applicant is not the homeowner:: J�
Contractor name 0 �-�/
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 hearby certify that the information contained herein is true and accurate to the best of my
knowledge. r
�:y
DATE: / U � APPLICANT'S SIGNATU (01
DATE: ? HOMEOWNER'S SIGN T E w
APPROVED
DATE: BUILDING OFFICIAL
697 FLORENCE RD BP-2016-0709
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 37-068 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Catec,orv: woodstove BUILDING PERMIT
Permit# BP-2016-0709
Project# JS-2016-001191
Est. Cost: $5000.00
Fee: $40.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: OLD HADLEIGH HEARTH & HOME CENTER 98784
Lot Size(sa. ft.): 53143.20 Owner: DIDONNA PAUL J&LINDA M
Zoninz: Applicant. DIDONNA PAUL J & LINDA M
AT: 697 FLORENCE RD
Applicant Address: Phone: Insurance:
697 FLORENCE RD (413) 584-6615 O WC
FLORENCEMA01062 ISSUED ON.1112312015 0:00:00
TO PERFORM THE FOLLOWING WORK.INSTALL HEARTHSTONE WOODSTOVE INSERT
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:
TIIIS 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:
Biiilding 11/23/2015 0:00:00 $40.00
212 Main Street, Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner