29-261 (2) � G
(CitV of Xort4an yton
Z
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DEPARTMENT OF BUILDING INSPECTIONS
INSPECTOR 212 Main Street ' Municipal Building _
Northampton, Mass. 01060
SOLID FUEL BURNING APPLIANCE & CHIMNEY APPLICATION
Page Plot C Zoned Permit Number
Location S,f
Owner or Lessee 7 7
� (Tele. No.)
Contractor '(
License Number)
Address
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 it
Labeled Combination
Date of purchase Furnace
Fireplace Insert
Model or Type of Appliance
Manufacturer
Purchased From
Name of Firm
(Address)
Cost - Construction & Appliance: "''-C�
Chimney /` New Metal Bestos
i#sed EXIST/'YG' Interior Chimney
Separate Flue L Exterior Chimney
Other appliance attached to flue
Masonary/lined
Unlined
Notes & Data:
Signature of Applicant: L ^'
Building Inspector Approval: / `/1
Date:
Depattmegt of Building Inspections
212MAn Street BUILDING i~
Northampton, Mass. 01060 0 tc , CC)
PERMIT
29 - 261 VALIDATION
DATE September 19, 19 83 PERMIT NO. 466
APPLICANT Gilbert Mitchell ADDRESS 3A0 Rrnnkside Circle NJA
(NO.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO Wood Burning Stove(-) STORY One Farili jy DWELLING UNITS _
(TYPE OF IMPROVEMENT) NO. (PROPISSED USE)
AT (LOCATION) 380 Brookside Circle ZONING
DISTRICT LjRA
(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 wood burning stove
AREA OR 900.00 PERMIT 10.00
VOLUME ESTIMATED COST .$ FEE $
(CUSIC/SQUARE FEET)
OWNER Gilbert Mitchell
BUIL
ADDRESS TOO S e Circle BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - A� SSORS COPY