29-266 (3) r
af �xssacpuseii. _
i
DEPARTMENT OF BUILDDQG INSPECTIONS
INSPECTOR 212 Main Street ' Municipal Building ,>r
Northampton, Mass. 01060
SOLID FUEL BURNING APPLIANCE & CHIMNEY APPLICATION C"
Page 3t Plot Zone
Location Lo VA f 11-k-1i
No. _ (St t)
Owner or � P .bL�L� �d
Lessee (Name . Mailing A+ ress) (Tel. No.)
Contractor
Name (Address) Tel. No.
RESIDENTIAL NONRESIDENTIAL
One Family Home Business
Two or More Other
Number of Units Specify
Type of Appliance
New L�-40od Burning'
�% ,Used Coal
Labeled Combination
r ,Bate of Purchase Other
Specify 1
Model or Type -1,�C`..i�t�
Manufacturer L\r�,�t ,�,. �� 1 � �1 -� � t01,tt�- Co
Purchased From C T I s�
010e of Firm
Address
Cost - Construction & Appliance S� f
Chimney New -4xi s ting
Se crate Flue Other Appliance Attached
To Flue
Masonary/Lined Metal Bestos
�Asonary/Unlined
xterior Interior
Notes & rata:
Signature of Applicant:
(Address)
Approved By:
(Title) (Date)
a DEPT. OF BUILDING INSPECTIONS BUILDING �°-
! 212 Main Street o<
I IL
Northampton, MA 01060 PERMIT
4D br
29 - *1= VALIDATION
DATE - November 13, )g 84 PERMIT NO. 637
APPLICANT Corey P. Wood ADDRESS 60 Longview Drive Owner
' l (NO.) (STREET) (CONTR'S LICENSE)
Wood Burnih Stove One Family ome NUMBER OF
PERMIT TO 1_I STORY__ y DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
60 Lon g view Drive ZONING
AT (LOCATION) 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 for the installation of a wood burning stove
AREA VOLUME ESTIMATED COST $ 500.00 used PERMIT 10.00
(CUBIC/SQUARE FEET) .,
Corey P. Wood
OWNER '
BULL
ADDRESS 60 T.nngvi Pw Dri VP BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY p 0.6p