31D-207 (2) City of Northampton
� Massachusetts
DEPARTMENT OF BUILDING INSPECTIONS `
212 Main Street • Municipal BuildingJ. b"
Northampton, MA 01060CEIVED &2—
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FEB 1 2 2020 S NGLE OR TWO FAMILY SOLID FUEL APPLIANCE PERMIT APPLICATION
FC R W OD, COAL, PELLET, CORN, STRAW OR SIMILAR,STOYES, OR FIREPLACES
DEPT.OF EUILDING INSPECTIONS Check# Kal- UU
NORTHAMP?ON.MA 01060
Please fill in all appropriate information
1. Name of Applicant : :�U o A�V-S
Address: 3 ) Fa {�'►I� "�-� �/�c�Ce- Telephone:
2. Owner of Property o A kves
Address: Saw,{ OL 2. Telephone: 5gme.
3. Status of Applicant: Owner Contractor
4. Type or Brand of Stove : 1 `1 Sc Lo p V`1 Se
5. UL Listing
6. Estimated Cost : c c
7. Email
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: t APPLICANT'S SIGNATURE
,Z iZ l l
APPROVED
DATE: 2- IZ- 2-OW BUILDING OFFICIAL /
0 35 FORT HILL TER BP-2020-0918
cls#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:31 D-207 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 P E RM I T
Permit# BP-2020-0918
Proiect# JS-2020-001560
Est.Cost: $5000.00
Fee:$40.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use croup: Homeowner as Contractor
Lot Size(sq. ft.): 3876.84 Owner. ALVES JULIO
Zoning: URC(100)/ Applicant. ALVES JULIO
AT. 35 FORT HILL TER
Applicant Address: Phone: Insurance:
35 FORT HILL TERR (413) 585-3033 ()
NORTHAMPTON MAO 1060 ISSUED ON:2/12/2020 0:00:00
TO PERFORM THE FOLLOWING WORK.-FIRE PLACE INSERT
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: d./
Rough: Oil: Insulation:
Final: Smoke: Final:
THIS PERMIT MAYBE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND RE ULATIONS.
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Certificate of si nature:
FeeTyue: Date Paid: Amount:
Building 2/12/2020 0:00:00 $40.00
212 Main Street,Phone(413)587-1240, Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner