29-251 (10) s +.
O
E-AR of Nort4am tOlt
� f /b1.s.achu.ett.
DEPARTMENT OF BUILDING INSPECTIONS = ,
INSPECTOR 212 Main Street ' Municipal Building t
Northampton, Mass. 01060
SOLID FUEL BURNING APPLIANCE & CHIMNEY APPLICATION
f ^�
Page Plot Zone Ujif- Permit Number
Location 15V r:512-400 <L .✓'
Owner or Lessee ! �/ ANGIL I t
Contractor a0 Tele. No.)
Address License Number)
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 "
Labeled Combination
Date of purchase Furnace
i
Fireplace Insert
Model or Type of Appliance
Manufacturer
Purchased From
Name of Firm
(Address)
Cost - Construction & Appliance: $ _ S7J ta0
Chimney New Metal Bestos
V_ Existing Interior Chimney
Separate Flue Exterior Chimney
Other appliance attached to flue
Masonary/lined
Unlined
Notes & Data:
!a n
Signature of Applicant: ` ��
Building Inspector Approval:
Date: 3, ��
department of Building Inspections
212 Main Street
iort�hamon, Mass. 01060 BUILDING '_
29 - 251 PERMIT
p VALID AT ION
DATE November 3, tg 83 PERMIT NO. 642
APPLICANT ADDRESS
Ken Aeolic 61 Overlook Dr. Owner
(NO.) (STREET) (CONTR'S LICENSE)OF
PERMIT TO Install Wood Burning StoyeSTORY One Family NUMBERNG UNITS
(TYPE OF IMPROVEMENT) ` N0. (PROPOSEO USE)
Overlook rive ZONING UKA
AT (LOCATION) DISTRICT
(NO.) (STREET)
Ar
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 used wood burning stove (Vigilant) with an existing
interior c imney.
AREA OR 550.00 PERMIT $ 10.00
VOLUME ESTIMATED COST FEE
(CUBIC/SQUARE FEET)
Ken Aeolic
OWNER 6t Overtook . BUILDI
ADDRESS � BY
WHITE - FILE COPY . GREEN - FIELD COPY - CANARY • APPLICANT COPY - PINK - AS ESSORS COPY