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17A-019 (3) 120 BRIDGE RD BP-2017-0067 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 17A-019 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-2017-0067 Project# JS-2017-000121 Est. Cost: $1200.00 Fee: $40.00 PERMISSION IS HEREBY GRANTED TO: ConstClass: Contractor: License: u:e Group: Homeowner as Contractor Lot Size(sq. ft.): 14984.64 Owner: PIZIALI AARON A&KATHRYN V SWAIM Zoning: RI(100)/URA(100)/ Applicant: PIZIALI AARON A & KATHRYN V SWAIM AT: 120 BRIDGE RD Applicant Address: Phone: Insurance: 120 BRIDGE RD FLORENCEMA01062 ISSUED ON:7/20/2016 0:00:00 TO PERFORM THE FOLLOWING WORK:INSTALL MORSO 1210 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: 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 7/20/2016 0:00:00 $40.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner City of Northampton MassachusettsA+ Pr 4 •. 0 s 1tt �� ,r DEPARTMENT OF BUILDING INSPECTIONS c _ R� 212 Main Street • Municipal Building ZL AEC-W. Northampton, !Q 01060 444 wg°' � pp -W. Fp "t120ZW6 SINGL a: U FA ILY SOLID FUEL APPLIANCE PERMIT APPLICATION FOR WOOD, COAL, PELLET, CORN, STRAW OR SIMILAR STOVES,OR FIREPLACES Check# Please fill in all appropriate information 1. Name of Applicant : AA gr) � k r{Lt ILS SYN 3ln>14\w\ Address: 1 Zr) 2A t Eck ,, 204LCh Telephone: 4 l3 ' 320 - (.°L.( 2_0 2. Owner of Property : Wv?t'N PI2lALA -- VGA'C7k(Z‘1N S'v01A1vv' Address: 12 ci' LSC-C Telephone: -32c, ( L1 2 0 3. Status of Applicant : ✓ Owner Contractor , ,J� 4. Type or Brand of Stove : 11\A 09---S l7I O :vis c', c -k- L V"Q 5. Estimated Cost: W CA S 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. 2 DATE: .7• 2G - I (c APPLICANT'S SIGNATUR' ,� ° — y� ; L�(,l DATE: `7 - 2 C • I HOMEOWNER'S SIGNATUR a �f � APPROVED DATE: BUILDING OFFICIAL