43-145 (2) 151 GREENL.eAF DR BP-2019-1369
61S#: COMMONWEALTH OF MASSACHUSETTS
Map�Block:43- 145 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Catceorwoodstow BUILDING PERMIT
Permit# BP-2019-1369
Project 11 JS-2019-002205
Est. Cost:
Fee: $40.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: Homeowner as Contractor—
Lot Sizc(sq. IFy 41294.88
ontractor_LotSizclsa. IFy41294.88 Owner. SAYER EDWARDJ & AMANDAREIL.LY
zonJnE Applicant. SAYER EDWARD J & AMANDA REILLY
AT. 151 GREENLEAF DR
Applicant Address: Phone: Insurance:
151 GREENLEAF DR
FLORENCEMA01062 ISSUED ON.513012019 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: House N 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:
FeeTvpe: Date Paid: Amount:
Building 5/302019 tr,00:00 $40.00
212 Main Street, Phone(413)587-1240. Fax:(413)587-1272
Louis Hasbrouck- Building Commissioner
City of Northampton _
Massachuse
RECEIVE
DEPARTMENT OF BUILDIN IN ECTION
212 Main Street • M Ic ps1 wilding +lC�
xortnampeo.,, M 0106 SAY 3 0 7019
`it, lJ w DEPT
NS
copy NORTdaIO .NMSP0O0Tm
SINGLE OR TWO FAMILY SOLID FUEL APPLIANCE PERMIT APPLICATION
FOR WOOD,COAL, PELLET,CORN,STRAW OR SIMILAR STOVES,O/R/FIREPLACES p
Q Check# gY'
v P= Please fill in all appropriate information
5
1. Name of Applicant. ( �✓ 2 J �� t�2�
Address: ' f(�A G E/4'!� D ��f�E Telephone78o-f 8
2. Owner of Property : S'fl .44 Lr
Address: / Telephone:
3. Status of Applicant: Owner Contractor
4. Type or Brand of Stove : cc)
5. UL Listing :
6, Estimated Cost /t "
7. Email : L /{�
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 nearby 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. 7- 30'2019 BUILDING OFFICIAL