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30A-024 42 LEXINGTON AVE BP-2016-1246 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 30A-024 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-2016-1246 Project# JS-2016-002140 Est. Cost: $1200.00 Fee: $40.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Homeowner as Contractor Lot Size(sq. ft.): 10410.84 Owner: HINDMARSH,WALTER G zoninc: URB(100)/ Applicant: HINDMARSH WALTER G AT. 42 LEXINGTON AVE Applicant Address: Phone: Insurance: 42 LEXINGTON AVE _ 413) 584-1437 () FLORENCEMA01062 ISSUED ON:4/25/2016 0:00:00 TO PERFORM THE FOLLOWING WORK.-INSTALL REGENCY 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 4/25/2016 0:00:00 $40.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner City of Northampton Massachusetts A ell T OF BUIZDING INSPECTIONS z ii 212 Mai Street • Municipal Building yJy cD� G 2016 1 rthampton, MA 01060 apR 2 ;pr4S DET4�.�;;{ i^{r10N,,4v1AC1Gb SINGLE OR TWO FAMILY SOLID FUEL APPLIANCE PERMIT APPLICATION FOR WOOD,COAL,PELLET,CORN,STRAW OR SIMILAR STOVES,OR FIREPLACES Check# Plea/se fill in all appropriate information 1. Name of Applicant : Wa �71 t cl- //�f -11 6y411A Address: q,Z L. e k �'�u vn .�v e. /vt e, c r Telephone: 2. Owner of Property : Address: S o. y e Telephone: J e-" -e 3. Status of Applicant: Owner Contractor 4. Type or Brand of Stove 11 5. Estimated Cost Z a v , a 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. v ,-�ATE: /(, APPLICANT'S SIGNATURE DATE: HOMEOWNER'S SIGNATURE APPROVED DATE: BUILDING OFFICIAL