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DEPARTMENT OP BUILDING INSPECTIONS
212 Main Street * Municipal Building
INSPECTOR Northampton, Mass. 01060
SOLID FUEL BURNING APPLIANCE & CHIMNEY APPLICATION PERMIT HUMBER
3 Page Plot Zone
Location
Owner or Lessee 0 ,
(Name) (Mailing Address) (Tele. No.
Contractor 4P'&0L1L+_ Lje
(Name) (-4411)40 (Address) (Tele. No.)
RESIDENTIAL NON-RESIDENTIAL
One family Home Business
Two or More Other
Number of Units Specify
Stories in Building
Type of Appliance ,
New Wood burning
Used Coal
Labeled Combination
Date of Purchase Other
Specify
Model or Type lks
Manufacturer
Z"
Purchased From
(Name of FArm)
(Addre�s)
Cost Construction & Appliance $ C>�/-
Chimney u New Metal Bestos
Existing Interior chimney
Separate Flue Exterior chimney
Other appliance attached to flue
Masonary Lined
Unlined
Notes & Data:
Signature of Applicant:
(Address)
Approved By:
Title: Date:d, 4 4��
DEPT. OF BUILDING INSPECTIONS BUILDING ZO +
212 Main Street o a
' Northampton, MA 01060 PERMIT a
29 - 3 VALIDATION
r DATE Decemper 21 , 1g 87 PERMIT NO. 836
APPLICANT Roaer All croft ADDRESS 71 Gilrain Terr. . Florence Owner
(N0.1 (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO Wood Burn i na �t OVe (_) STORY One Family DWELLING UNITS
(TYPE Of I.PROY .ENT) NO. (PROPOSED SE)
71 Gi l ra in Terr Florence ZONING URA
AT (LOCATION) ► DISTAICT
(N0.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS: pPrini t for t t1P 7 nCt A l l at j nn of a new wood burning sl u)A
AREA OR ESTIMATED COST $ 2,600.00 PERMIT $ 10.00
VOLUME
(CUBIC/SQUARE FEET)
OWNER Same as Applicant c
ame as Applicant's By '40.
ADDRESS
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY plA p