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16C-003 (10)
City of Northampton / D V ssachusetts ,G -,kl DEPAR OF BUILDING INSPECTIONS a OC 1 2(J treat • Municipal Building o hampton, MA 01060 r �y4 EjocWc,Plumbing&Gas Inspeotlora Northampton,MA 01060 SINGLE OR TWO FAMILY SOLID FUEL APPLIANCE PERMIT APPLICATION FOR WOOD, COAL, PELLET, CORY, STRAW OR SIMILAR STOVES, OR FIREPLACE INSERTS Permit Fee: Check# PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant, © c--1 vyy i f-- Address: S ) S\FI"��N� S� ,,(Z4 t�� t�^°� ('" elephone: Li t 3'-3,A t - 3-7-57 2. Owner of Property: C�<<- PI"larNi Address: 33`1 C IO6'4 Telephone: `-1 i 3 -Z�-7-732(= 3. Status of Applicant: V/Owner Contractor 4. Type or Brand of Stove: �'52+�r i S �w' ''`4 CG'00 7L' If applicant is not the homeowner: 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 5. Certification: I hereby certify that the information contained her ' true and accurate to the best of my knowledge. DATE: 2- (S APPLICANT'S SIGNATURE DATE: HOMEOWNER'S SIGNATURE —' APPROVED DATE: BUILDING OFFICIAL 334 SPRING ST BP-2016-0448 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 16C-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: woodstove BUILDING PERMIT Permit# BP-2016-0448 Project# JS-2016-000739 Est.Cost: Fee: $40.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: Homeowner as Contractor Lot Size(sq. ft.): 43864.92 Owner: LANGMUIR JONATHAN Zoning.URA(,100)/WSP(100)/ Applicant: LANGMUIR JONATHAN AT: 334 SPRING ST Applicant Address: Phone: Insurance: 334 SPRING ST (413)237-7326 0 FLORENCEMA01062 ISSUED ON.101212015 0:00:00 TO PERFORM THE FOLLOWING WORK.-INSTALL ENERZONE EP00070 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# 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 10/2/2015 0:00:00 $40.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner