29-123 (6) DEPARTMENT OF BUILDING INSPECTIONS
INSPECTOR 212 Main Street • Municipal Building ,
Northampton, Mass. 01060_
SOLID FUEL BURNING APPLIANCE & CHI EMN Y APPLICATION PERMIT NUMBER
Page Plot Zone �`�— '
Location f`lam Ay�!'/j,' �d
Owner or Lessee r Cci�T% l <= `f d�yl`ti'I?
Name) Mailing Address) Tele. No. )
Contractor 1P, T 1- ✓? , 15-
(Name) (Address) (Tele. No.)
RESIDENTIAL NON-RESIDENTIAL
One family Home Business
Two or More Other
Number of Units Specify
Stories in Building
Type of App 11 ane-e
New Wood burning
Usbd Coal
Labeled Combination
Date of Purchase Other
Specify
� r YPe
( � Manufacturer
Purchased From
(Name of Firm)
(Address)
Cost - Construction & Appliance
Chimney V New Metal Bestos
Existing Interior chimney
Separate Flue Exterior chimney
Other appliance attached to flue
Masonary Lined
Unlined
Notes & Data:
Signature of Applicant:
(Add-kiss)
Approved By:
�I
Title: Date:
DEPT. OF BUILDING INSPECTIONS
BUILDING
212 Main Street O<
Northampton, MA 01060 PERMIT
29 - 123 VALIDATION
Helen Waite DATE April 5, 19 89 PERMIT NO. 197
APPLICANT ADDRESS 441 Ryan Rd. Owner
(NO.1 (STREET) (CONTR•S LICENSE1
NUMBER OF
PERMIT TO Install Chimney (_I STORY One Family DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
AT (LOCATION) 443 IZVAn RC1dC1 ZONING CT URA
(N0.) (ST EETI
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 chimney
AREA OR 160.00 PERMIT 10.00
VOLUME ESTIMATED COST $ FEE tft
(CUBIC/SQUARE FEET) ��
OWNER Same as Applicant
ADDRESS Same as Applicant's BUI
BY
Aub WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY p'IRf' ' p