29-286 (4) k
r
s r
.'(AA I FULL r'ki1„rIIIG' Iri'['
t'rZ;e _ }'lr r.,ra Ptr�ni t N!a�trt>arr L
(Tele. No. )
st,I IDE:NTIAL. Nti3N_1 f ;I1)1-'NTIAL
Two or More N nrr1 1 c.f 11 nitr. � .I�>- . (Specify)
Floors i n Bldg,
_ .._..�. ___._ ......._... _ �_
New �..... bcod Burnin
Used Coal ,
Labeled CorrrhinatIonj
Date of p u r c h ri s e _ F u rn a c e
Fireplace Insert
Model or Type of Appliance
Manufacturer
Purchased FTo.m
h, x me i� Firm)
AddresO
Cost - Construction 6 Appliances �,23e G
Chimney New Metal Bestos
Existing Interior Chimney
Separate Fluc Exterior Chimney
Other appliance attached to flue
h4asonaryjl ined
Unlined
Notes 6 Data:
Signature of Applicant: - "��
building Inspector Approval.:
Date:
e DEPT. OF BUILDING INSPECTIONS BUILDING '°_
212 Main Street 0<
Northampton, MA 01060 PERMIT
29 - 286 VALIDATION
DATE July 29, 19 86 PERMIT NO. 431
APPLICANT Samuel Adams ADDRESS 28 Pencasal Drive Owner
(N0.) (STREET) (CONTR•S LICENSE)
PERMIT TO CnaI Burnin NUMBER OF
y�QQ(� X�QI��� cg�to�ORY— One Family DWELLING UNITS
(TYPE OF IMPROVEMEONT) NO. (PROPOSED USE)
AT (LOCATION) 28 Pencasal Drive ZONING URA
DISTRICT
(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 fnr t.hP installation of a Hd6d6MXXX combination wood coal burning stove
VOLUME ESTIMATED COST $ 2,300,(RHEMIT $ 10.00
(CUBIC/SQUARE FEET) �FE
OWNER Same as Aop.licant BUILD
ADDRESS Same as A6,61 Kant'g BY t.'�,'
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY po...fp