35-026 (2) <r
FULL �l`iii<xt�`( iJILIANCL. f C':IIMNl,,,Y A 'F'LICATION
V e t j
- -,�� t Fctdntbcr
a.z C.f C i 011
t,tiaticr or Lessee
_... Te l e. No. )
Con t rac t.-or
ess
RESIDENTIAL ih0k--14,LS s 1:1L'N=lAl,
One Fami I Lowe _ _ I., irze:4s _
Two or More of Units
Floors in Flag.
1"ype of Appliance:
New L-' Wood Burning
Used CO&I
_ Labeled Comb inn ti on
Date of purchase: Furnace
Fireplace. Insert
Model or Type of Appliance �) .e a j rL)P
Manufacturer
Purchased From -k
� sme of Firm)
(Address)
Cost - Construction & Appliance: .'z 0 0, �U
Chimney New Metal Bestos
�X Existing ___,,Y Interior Chimney
Separate Flue Exterior Chimney
Other appliance attached to flue.
Masonary/lined
Unlined
Notes 6 Data:
Signature of Applicant.:
Building Inspector Approval: �i
Date: " / �9
a DEPT. OF BUILDING INSPECTIONS BUILDING Z° 4
0
212 Main Street Q
Northampton, MA 01060 PERMIT
35 — 26 VALIDATION
DATE June 26, (g 86 PERMIT NO. 338
APPLICANT Donna R. Scagel ADDRESS 54 Ryan Road er
(NO.) (STREET) (CONTR'S LICENSE)
PERMIT TO Wood Burning X= STORY One Family DWELL RING or
UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
1054 Ryan Road, Florence ZONING SR
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)
permit for the installation of a wood burning stove)OM (new)
REMARKS:
AREA OR ESTIMATED COST $ 800.00 PEE $ 10.00
VOLUME
(CUBIC/SQUARE FEET)
OWNER Donna R. Scagel Z< ,
Ryan ., Florence By
I LD
ADDRESS
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY PINT P