16B-043 267 NORTH MAIN ST BP-2017-0912
GIS a: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 16B-043 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
Permitf BP-2017-0912
Project# JS-2017-001558
Est.Cost:
Fee: $40.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: Homeowner as Contractor
Lot Size(sq. ft.): 18687.24 Owner: JOSEPH CLARENCE&KAREY
Zoning: URB(100)/ Applicant: JOSEPH CLARENCE & KAREY
AT: 267 NORTH MAIN ST
Applicant Address: Phone: Insurance:
267 NO MAIN ST
FLORENCEMA01062 ISSUED ON:2/2/2017 0:00:00
TO PERFORM THE FOLLOWING WORK:PELLET 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 it 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 2/2/2017 0:00:00 $40.00
212 Main Street,Phone(413)587-1240, Fax: (413)587-1272
Louis Hasbrouck--Building Commissioner
City of Northampton
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;Massachusetts
4. DEPARTMENT OF BUILDING INSPECTIONS
` N 222 Main rthaet o Municipal Building
\, tzit Northampton, MA 01060 4.0/
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cV SINGLE OR TWO FAMILY SOLID FUEL APPLIANCE PERMIT APPLICATION
1
rco FOR WOOD,COAL,PELLET,CORN,STRAW OR SIMILAR STOVES,OR FIREPLACES
Li-
Check#
Please fill in all appropriate information
1. Name of Appli��c^^ant : `C",�/,4tc /�!(r=- -IG'52:7//
Address: .9 2- - /V ' /59if/N ,S'i /SGC& 'V(f/Telephone: ¶8'h 63-5/1"
2. Owner of Property: G-. - (Yr S;r-Hl1
Address: Leta 672 Nr //4 tAt si: X Pte%✓tdr Telephone:
3. Status of Applicant: Owner r/ Contractor
4. Type or Brand of Stove : ./ //erV9/AN7)) s _
5. Estimated Cost : /
If applicant is not the homeowner::
Contractor name
Construction Supervisors 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: , cr7�7 APPLICANTS SIGNATURE ,,,. 'c"n/c to cczy. ` .:;if 1}
71
DATE: HOMEOWNER'S SIGNATURE
APPROVED
/
DATE: i -(9- -72 BUILDING OFFI' �J/