30A-021 23 BOTTOMS RD BP-2017-0720
GBS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 30A-021 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-2017-0720
Project# JS-2017-001187
Est.Cost:$2600.00
Fee:$40.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
use Gronp Homeowner as Contractor_
Lot Size(sq,N.): 110206.80 Owner: ETNIER-JACKSON DIANE& RAY M JACKSON
Zoning:SR(107yWP(34)/ Applicant: ETHIER-JACKSON DIANE & RAY M JACKSON
AT: 23 BOTTOMS RD
Applicant Address: Phone: Insurance:
23 BOTTUMS RD
FLORENCEMA01062 ISSUED ON:II/28/20I6 0:00:00
TO PERFORM THE FOLLOWING WORK:WOOD 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: Rouse# 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 11/28/'20160:00:00 $40.00
212 Main Street. Phone(413)587-1240, Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
City of Northampton
• Massachusetts a� g
.
tt *'4 DEPARTMENT OF BUILDING INSPFOTICNS
212 main Street a lfunicipa1 Bei Larne
J` n
L _ Northampton, !A 01060 FrryjJC
3
4
, SINGLE OR TWO FAMILY SOLID FUEL APPLIANCE PERMIT APPLICATION
FOR W000,COAL,PELLET,CORN,STRAW OR SIMILAR STOVES,/� OR FIREPLACES
Check# Opt Ve '7Lr
Please fill in all appropriate information
1. Name of Applicant: / A j41 - t A.ks >,
Address: (2-3 130 I/ Telephone' 4%9 -647c- 7 it.c."-
2.
2. Owner of Property: ,S/Lea c.
Address: Telephone:
3. Status of Applicant: L./Owner
Owner Contractor
4. Type or Brand of Stove
5. Estimated Cost: �C1 €> O . L'.
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
a 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