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Notes & Data:
Signature of Applicant:
Building Inspector Approvals /
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s a DEPT. OF BUILDING INSPECTIONS BUILDING
+ ! 212 Main Street Oa IL
Northampton, MA 01060 PERMIT .9
29 - 173 VALIDATION
D Mrs. DATE September. 26 19 8 P MIT NO. 567
APPLICANT Mr. & Mrs. Louis Bach 1 eer lel �rlve Owners
ADDRESS
(NO.) (STREET) (CONTR'S LICENSE)
OF
Wood Burning Stove One Family Home DWELLR
PERMIT TO (_) STORY
DWELLING NUMBER
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
ZONING
AT (LOCATION)
110 Deerfield Drive DIISTR CT AT
(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 13ASEMENT WALLS OR FOUNDATION
(TYPE)
permit for the instAllation of a waterford 103 wood burning stove
REMARKS:
AREA OR ESTIMATED COST $ 359.00 FEEMIT $ 10.00
VOLUME
(CUBIC/SQUARE FEET)
OWNER Same as Applicant
Same as Applicant's BUILDI
ADDRESS BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY pop