29-253 (3) lz C
DEPT.Of BUI "M lh5"F^MNS
of Nort4amptott
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DEPARTMENT OF BUILDITIG INSPECTIONS
INSPECTOR 218 Main Street ' Municipal Building
Northampton, Mass. 01060 PiRm
SOLID FUEL BURNING APPLIANCE 6 CHIMNEY APPLICATION
Page P/lot � Zone
Location r ' � "fig I) / c
Owner or
Lessee Nine — ( ailing Address) (Tel. No.
Contractor
ne Address —TT-41. No.
RESIDENTIAL NONRESIDENTIAL
One Family Home Business
_
Two or More Other
Number of Units Specify
Type of Appliance
Nev �Wood Burning
Used Coal
Labeled Combination
Date of Purchase Other
`r,1 Specify
Model or Type ° Gil
Manufacturer �GLt;? d Z, ;
Purchased From /c
o Firm
z. Vin.,
Gas)
_ dr
Constructs i AppliancCost a
Chimty rev ��_., Existing v
'
Separate Flue Other Appliance Attached
To Flue
Masonry/Lined Metal Bestos
_ Masonary/Unlined
_ Exterior Interior
Notes 6 Data:
Signature of Applicant:
(Address)
Approved Byt
zo,//7c�lyo
Title to
Department of Building Inspections
212 Main Street
Noryp#*01bn, Ma. 01060 BUILDING zo
29 - 253 PERMIT a AQ- 00
VALIDATION
DATE 1)PCpmhpr 2. i19 A2 PERMIT NO. A71
APPLICANT John Alexander ADDRESS 71 Overlook nr.
(NO.) (STREET) (CONTR'S LICENSE)
NUMBER OF 1
PERMIT TO WAOa Stove (�_) STORY DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSE 5E)
ZONING
AT (LOCATION) 77 Overlook Drive DISTRICT JIB
(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: Ins,t>'71, wood burning—stove in exi tting rhimineq, separate flue
- basement area
AREA OR
VOLUME ESTIMATED COST $ 925_(10 FEEMIT $ 10_00
(CUBIC/SQUARE FEET)
,r
OWNER John Alexander
ADDRESS 77 Overlook Drive, Fl orpnep, Maw 01060 Bu DI
WHITE - FILE COPY • GREEN - FIELD COPY • CANARY - APPLICANT COPY PINK - ASSESSORS COPY