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DEPARTMENT OF BUILDING INSPECTIONS
INSPECTOR 212 Main Street ' Municipal Building
Northampton, Mass. 01060
PiEMIT
SOLID FUEL BURNING APPLIANCE 6 CHIMNEY APPLICATION
Page Plot _—
— Zone
Location 1X10 - U�IpA '1-aerr,s
No. jj Street
Owner or V1,,,,ylro(t 171a ni�1?Y)e l Y -lairs 2S a-b0 LLq-
Lessee Name Mailing Address ?Tel. No.
Contractor
(Name) Address Tel. No.
RESIDENTIAL NONRESIDENTIAL
✓ One Family Home Business
Two or More Other
Number of Units _ Specify
Type of Appliance
1! New ✓ Wood Burning
_ Used Coal
Labeled Combination
g/T1 Date of Purchase Other
Specify
Model or Type bC a t(-k CA-
Manufactures ' =4�..., G�,IP
Purchased Fron �l b T z 40-L'S 3,k3
- (Nam of Firm —
3f Ae' c: 'Y LaL-4
%AQUYS66.1
Cost • Construction i Appliance $ `26®, od
Chimney New I/ Existing
Separats Flue Other Appliance Attached
To Flue
_ Masonary/Lined Metal Bestos
_ Masonary/Unlined
_ Exterior Interior
Notes 6 Dates
(�r-1� Alhws Yq
Signature of Applicants ) �t ' L3-4�" s
(Address)
Approved By$
(Title) to
DEPARTMENT OF BUILDING INSPECTIONS
�. 212 MAIN STREET BUILDING ° /QOQ
NORTHAMPTON, MA. 01060 PERMIT
0 d
35 - 38
VA IOATION
DATE Octriber 28f 19 81 PERMIT NO. -.604,
APPLICANT Edgard aasta.in ADDRESS 19C) Wegt_ Farms Road
(NO.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO (`) STORY Wood burnin stove DWELLING UNITS 1
PE O IMPROVEMENT) N0. (PROPO D USE)
L ZONING
AT (LOCATION) 1 Q( Wept FaL[ S oad
DISTRICT SR
(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: TnS tal 1_ wood burning stove in existing chimney
AREA OR PERMIT
VOLUME (CUBIC/SQUARE FEET) ESTIMATED COST $ 7n
1� .A0 FEE $. 1 nn
�
OWNER Fdward & Marlene Chastain
ADDRESS
190 West Farms R ,_� Nnrthamrtpnr Mme„ n1�6o BY l PT
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY - PINK - ASSESSORS COPY