11C-030 1\
) &_- 41
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DEPARTMENT OF BUILDITIG INSPECTIONS • WIN 41
INSPECTOR 212 Main Street • Municipal Building ‘.]:41P.
�, : 4
Northampton, Mass. 01060 "ow
SOLID FUEL BURNING APPLIANCE & CHIMNEY APPLICATION PERMIT NUMBER tly_
Page r Plot ( 30 Zone Lim
Location L E 4'9 s w& L
Owner or Lessee j7011r ie 1 � S S70 ( 4)/5 ". (- C ci c (. 1 _ 7C ) CY
(Name) Mailing Address) (Tele. No.)
Contractor S9/
(Name) (Address) (Tele. No.)
RESIDENTIAL NON- RESIDENTIAL
Z " - -- One family Home Business
Two or More Other
Number of Units Specify
Stories in Building
Type of Appliance
New Wood burning
)( Used Coal
Labeled Combination
Date of Purchase Other
Specify C /6 ��
Model or Type — i C '1.- LY-e -D
Manufacturer
Purchased From
(Name of Firm)
(Address)
Cost - Construction & Appliance $
- r /. c,c
Chimney �' New Metal Bestos
Existing _interior chimney
Separate Flue Exterior chimney
Other appliance attached to flue
Masonary Lined
Unlined
Notes & Data:
, J ` '
Signature of Applicant: k c � /� -��-' - �
ti. '�� (Address)
Approved By: Y Title: Date: // -- G
DEPT. OF BUILDING INSPECTIONS Z
BUILDING l < m
,
, 212 Main Street O<
2 EL
-> Northampton, MA 01060 PERMIT
11C - 30
VALIDATION
86 DATE November 3, 19 86 PERMIT NO. 648
APPLICANT Robert Bl a i s ADDRESS 5 Stowell Street uwner
(N0.) (STREET) (CONTR'S LICENSE)
PERMIT TO Wood Burning Stove( O Family Dwelling in NUMBER OF
_ ) STORY Y 9 DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
AT (LOCATION) 5 Stowell Street ZONING URA
DISTRICT
(N0.) (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: S. 11 • S. t •t • ••• t t t• • • . t 11t• • t * • At
stove.
AREA OR PERMIT
VOLUME ESTIMATED COST $ 250 00 FEE $ 10 nn
(CUBIC /SQUARE FEET)
OWNER Same as Applicant BUILDI ,V / �y�
ADDRESS Same as Applicant's BY �t�.li/r/,l �e .�
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - AS SSORS COPY pie P