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11-003 79 COUNTRY WAY BP-2017-0381 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 11 -003 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category:woodstoye BUILDING PERMIT Permit# BP-2017-0381 Project# JS-2017-000629 Est.Cost:$6192.00 Fee: $40.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: OLD HADLEIGH HEARTH & HOME CENTER 98784 Lot Size(sa.ft.): 23391.72 Owner: VOLPE ELENA Zoning: Applicant: OLD HADLEIGH HEARTH & HOME CENTER AT: 79 COUNTRY WAY Applicant Address: Phone: Insurance: 119 WILLIMANSETT ST (413) 538-9845 WC SOUTH HADLEYMA01075 ISSUED ON:9/20/20I6 0:00:00 TO PERFORM THE FOLLOWING WORK:1482 JOTUL STOVE 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 9/20/2016 0:00:00 $40.00 212 Main Street, Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner City of Northampton /011) Massachusetts '9�1( 6 `'9'-o.. `�s lDEPARTMENT OF BUILDING INSPECTIONS o 212 Main Northampton, • Municipal Building 16 n 1 1" Northampton, MA 01060 stkir 40` --. §g N 0) =_ '- =e SINGLE OR TWO FAMILY SOLID FUEL APPLIANCE PERMIT APPLICATION u of w? FOR WOOD,COAL, PELLET,CORN, STRAW OR SIMILAR STOVES,OR FIREPLACES 0 Check# /{"l0 (yr) 4 ) ( (l (L`OL10 Please fill in all appropriate information D 1. Name of Applicant: red", t frp f pt I' :717-5i '7 �/ Address: / 7 { (.©L(yih Witt/ 7T /va'vt ce Telephone: :7 7— et 2. Owner of Property : flel Lk:. yi 4- 6 kjen_f ice.11 i Address: 7 1 (LC 1-�� k� f-"(� /e 0. 0?.._ Telephone. 3. Status of Applicant :'" Owner Contractor 4. Type or Brand of Stove : Jo 5. UL Listing : It/501. . 6. Estimated Cost : ( 5 lCI - ' S-)i;ut ( t ) (( 2 . 3 (j it i I If applicant is not the homeowner:: Yl-� Contractor name ye G tit, 0,-,,t)C?1ski , ,2� �-d- ��� " o Construction Supervisor's License Number_f SSL Oci 5 f 5 V Expiration Date L 4.24 // 7 Home Improvement Contractor Registration Number hi /4 Y Expiration Date Ch It, /17 All Applicants must complete a Workers Compensation Insurance Affidavit before we can issue a permit 7. Certification: I hearby certify that the information contained herein is true and accurate to the best of my knowledge. DATE: VI 5// APPLICANT'S SIGNATURE 74 DATE: 6�/f��G" HOMEOWNER'S SIGNATURE 1 t f' APPROVED DATE: BUILDING OFFICIAL