25C-092 (3) City of Northampton
Massachusetts �.
2 DEPARTMENT OF BUILDING INSPECTIONS '
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 FIREPLACES
Check# 1X53,
Please fill in all appropriate information
1 t
1. Name of Applicant: 7C.
Address: `7 L nc° x A-u 0o(4,r6, Telephone:
2. Owner of Property C,;� ('�cue.� + V.C-r:e zT-own
Address: yg �C°�" Q!�� (� P Telephone: i1�3 7D3
3. Status of Applicant : x Owner Contractor
4. Type or Brand of Stove :. YA
5. Estimated Cost : <,i1 o Lni
If applicant is not the homeowner::
Contractor name
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.
DATE: APPLICANT'S SIGNATURE
DATE: HOMEOWNER'S SIGNATURE
APPROVED
DATE: BUILDING OFFICIAL
48 LINCOLN AVE BP-2016-0719
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 25C-092 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-2016-0719
Project# JS-2016-001203
Est. Cost: $2500.00
Fee: $40.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: Homeowner as Contractor
Lot Size(sq. ft.): 11282.04 Owner: MCNEIL CRAIG
zoning: URB(100)/ Applicant: MCNEIL CRAIG
AT. 48 LINCOLN AVE
Applicant Address: Phone: Insurance:
48 LINCOLN AVE (781) 738-9155 O
NORTHAMPTON MAO 1060 ISSUED ON:1112412015 0:00:00
TO PERFORM THE FOLLOWING WORK.-INSTALL YOTD 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 11/24/2015 0:00:00 $40.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner