17C-085 (6) 67 HIGH ST BP-2019-0518
GIS#: COMMONWEALTH OF MASSACHUSETTS
MW:Block: 17C-085 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-2019-0518
Proiect# JS-2019-000842
Est.Cost: $2400.00
Fee: $40.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: Homeowner as Contractor
Lot Size(sg.ft.) 6403.32 Owner: PARZYCH KEITH F
Zoning:URB(l00)/ Applicant: PARZYCH KEITH F
AT: 67 HIGH ST
Applicant Address: Phone: Insurance:
67 HIGH ST
FLORENCEMA01062 ISSUED ON:10/29/2018 0:00:00
TO PERFORM THE FOLLOWING WORK.-HEARTHSTONE 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 Sianature:
FeeType: Date Paid: Amount:
Building 10/29/2018 0:00:00 $40.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
City of Nor-t amptiorn
DEPARTMENT OF BUILDING INSPECTIONS �b
212 Main Street • Municipal Building "
Northampton, MA 01060
RECEIVED ,
, x _414
OCT 2 6 2018 6w P
V
ING E OR TWO FAMILY SOLID FUEL APPLIANCE PERMIT APPLICATION
DEPT OF BUILDING INSPECTIONS /
NORTHAMPTON.�
OD,COAL, PELLET,CORN,STRAW OR SIMILAR STOVES,OR FIREPLACES
Check# "l 66
9 PI se fill in all appropriate information
1. Name of Applicant: ✓� l f 1�
Address: (4:2 f l 9'/n /CrPo("e— Telephone:
2. Owner of Property
Address: Telephone:
3. Status of Applicant: 11 Owner / _J,Contractor !
4. Type or Brand of Stove : /7e'Gr r f
5. UL Listing :
6. Estimated Cost : 7
7. Email : &12 a✓'Z. q.� A121 f< QM
If applicant is not the homeowner::
Contractor name Email :
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
8. 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: lOJ-Z BUILDING OFFICIAL`' li