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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 ,5a 7, d� s .:, — ` � �` i ♦"l�4t Ww C ;Massachusetts 4. DEPARTMENT OF BUILDING INSPECTIONS ` N 222 Main rthaet o Municipal Building \, tzit Northampton, MA 01060 4.0/ ,CL AI7 II 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/