29-328 (2) �IGIMesRChnsetis - _
DEPARTMENT OF BUILDING INSPECTIONS
INSPECTOR 212 Main Street ' Municipal Building
Northampton, Mass. 01060
SOLID FUEL BURNING APPLIANCE & CHIMNEY APPLICATION PERMIT NUMBER _
Page Plot Zone
Location IL/
UD rte}. 'vo I.-- �J
Owner or Lessee
(Name) Mailing Address) (Tele. No.)
Contractor t =�
(Name) (Address) (Tele. No. )
RESIDENTIAL NON-RESIDENTIAL
Ine 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
Model or Type
Manufacturer
Purchased From
Name of Fi )
(Address)
Cost - Construction & Appliance $
Chimney New Metal Bestos
Existing Interior chimney
Separate Flue Exterior chimney
Other appliance attached to flue
Masonary Lined
Unlined
Notes & Data:
Signature of Applicant:
,,,,�—f� a (Address)
Approved By: C �""�1 r
c
Title: CO�1..- ,� �"�''�.,Y Date:
DEPT. OF BUILDING INSPECTIONS BUILDING Z
212 Main Street 'oa ; j !�
Northampton, MA 01060 PERMIT
29 - 328
VALIDATION
DATE January 9, 19 89 PERMIT No. 16
APPLICANT Lorraine Weimann ADDRESS 300 Acrebrook Dr. Owner
(NO.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO Wnnrl Rllrninn �tnVP (_) STORY_ One Family DWELLING UNITS
(TYPE OF IMPROVE ENT) N0. (PROPOSED USE)
ZONING
AT (LOCATION) .00 Acrehrook Dr- , Florence D STA CT URA
(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: _opr-wlt fnr the installation of A new wand burninq ctnVP
AREA OR 1 ,600.00 PERMIT 10.00
VOLUME ESTIMATED COST $ FEE s
(CUBIC/SQUARE FEET)
OWNER Same as Applicant
f�
—7a—me as Applicant' s BUILD�I• '�
ADDRESS BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY pop