29-408 (8) (EitV of Wort4umpton _=
• • �ASfAChltfttlf
DEPARTMENT OF BUILDING INSPECTIONS
INSPECTOR 212 Main Street • Municipal Building
Northampton, Mass. 01060
SOLID FUEL BURNING APPLIANCE 6 CHIMNEY APPLICATION
Page ; Plot Zone Permit Number .-
Location < C) ,� 7
Owner or Lessee f 2 L
r .
Contractor
(Tele. No.)
/
1 f �, License Number
Address y
RESIDENTIAL NON-RESIDENTIAL
One Family Home Business
Two or More Number of Units Other (Specify)
Floors in Bldg.
Type of Appliance:
New Wood Burning
Used Coal tt
Labeled Combination
Date of purchase Furnace
/ Fireplace Insert
Model or Type of Appliance ,
Manufacturer
Purchased From <
ame`of Pf rm
c '?
Addr ss)
Cost - Construction 6 Appliance:
Chimney New Metal Bestos
Existing Interior Chimney
Separate Flue Exterior Chimney
Other appliance attached to lue
fi Masonary/lined
Unlined
Notes 6 Data:
Signature of Applicant: C'w,
Building Inspector Approval:
Date:
Department of Building Inspections
212 Main Street
4040 pton, Mass. 01060 BUILDING Z°
29 - 408 PERMIT
I-a to . 0c),
VALIDATION
DATE December 8 19 83 a Ir o 682
Albert St. Onge —'S-a-nnc'y 1Ii1�I �oa�
APPLICANT ADDRESS
(NO.) (STREET) (CONTR'S LICENSE)
Wood Stove & Chimney One Family Home NUMBER OF
PERMIT TO (^) STORY DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (.PROPOSED USE)
Sand Hill Road ZONING URA
AT (LOCATION) y DISTRICT
(NO.) (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: permit for the installation of a new wood burning stove and a new exterior chimney
masonaryltinen.
AREA OR 850.00 PERMIT s 10.00
VOLUME ESTIMATED COST $ FEE
(CUBIC/SQUARE FEET)
OWNER Albert St. Onge
ADDRESS 9 Sandy Hi Road BBYIL
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY PINK - ASSESSORS COPY