29-387 (9) City a# 'Nart4almpt"
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DEPARTMENT OF BUILDING INSPECTIONS
INSPECTOR 212 Main Street ' Municipal Building
Northampton, Mass. 01060
PERMIT NUMBER
SOLID FUEL BURNING APPLIANCE 6 CHIMNEY APPLICATION
Page � Plot _L Zoae � }
Location
S tree 0
Owner or
Lessee (Name Mailing Address) Tel. No.
Contractor �� �� ',� �
(Nam&1 kAddTess) Tel. No.
RESIDENTIAL NONRESIDENTIAL
7' "– One Family Home Business
Two or More Other
Number of Units Specify
Type of Appliance
New Wood Burning
Used Coal
Labeled Combination
Date of Purchase Other
_it Specify
Model or Type
Manufacturer
Purchased From
Name of Firm
Address
Cost - Construction 6 Appliance $-L—�
C7hi ey New Existing
74 Separate Flue Other Appliance Attached
Flue
Maaonary/Lined Metal Beatoa
Masonary/Unlined
Exterior Interior
Notes Data: -
Signature of Applicant: ?� _.t,t LzW _
Address
Approved By:
�il�� (Title)� at
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DEPARTMENT OF BUILDING INSPECTIONS
ph,MAIN STREET BUILDING Z° c�j q
NORTHAMPTON, MA. 01060 0`a �, A �d-d'�
PERMIT a �°
29 - 387 VALIDATION
DATE September 1, 198, PERMIT NO. 516
APPLICANT Judith Glucksman ADDRESS !A3 Srnokwond Dri_vp
(NO.) (STREET) (CONTR'S LICENSE)
PERMIT TO wnnd stove NUMBER OF
(_�) STORY Wnnd..hurniin etnVe DWELLING UNITS 1 _
(TYPE OF IMPROVEMENT) NO. (PROPOSED g8E}
AT (LOCATION) 43 Brnokwood Drivp ZONING DISTRICT DISTRICT
(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: Rp A� icing two Loxigting chimnpirc, ingtallation of wood-blyrnfrIg StOYe ;*n
basement
AREA OR PERMIT
VOLUME ESTIMATED COST .� FEE $ 10y00
(CUBIC/SQUARE FEET)
OWNER William & Judith Glucksman
BU
ADDRESS 43 Arnnkwned Dr4ve,Nar� t�hamp nn._Ha- Q1060 e Ll,
WHITE - FILE COPY . GREEN - FIELD COPY CANARY - APPLICANT COPY • PINK - ASSESSORS COPY