29-355 (4) -WOO
O
i Q�ItV of Northampton
r � _
�1ASAAtI'/iA tttA =_
DEPARTMENT OF BUILDING INSPECTIONS
INSPECTOR 212 Main Street ' Municipal Building
Northampton, Mass. 01060
SOLID FUEL BURNING APPLIANCE & CHIMNEY APPLICATION
Page Plot Zone Permit Number
Location
Owner or Lessee Iclin 1 l:ir(ri
Contractor /J`j�, 2 Tele. No.)
✓
Address License Number)
RESIDENTIAL NON-RESIDENTIAL
One Family Home Business
Two or More Number of Units Other (Specify)
Floors in Bldg.
Type of Appliance:
New Wood Burning
Used _ Coal "
Labeled Combination
Date of purchase Furnace
Fireplace Insert
Model or Type of Appliance r'1C�('��rk>
Manufacturer
Purchased From
Nam of F rm NM
(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:
Building Inspector Approval: /'s r
Date:
Department of Building Inspections
21G M i Street p
Ncii+t aton, Mass. 01060 BUILDING oo (=j
29-355
PERMIT
VALIDATION
December 8, 83 679
DATE 19 PERMIT NO.
APPLICANT Michael XXXV€NX Graves ADDRESS A9 t1 JrCle Owne r
(NO.) (STREET) (CONTR'S LICENSE)
Wood Burning Stove One Family NUMBER of
PERMIT TO (,1 STORY DWELLING UNITS _
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
6 Austin Circle ZONING URA
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 with a existing chimney
AREA OR 650.00 PERMIT 10.00
VOLUME ESTIMATED COST $ FEE _
(CUBIC/SQUARE FEET)
OWNER Michael Graves
ADDRESS uS in Circle BU
f.
WHITE - FILE COPY ■ GREEN - FIELD COPY CANARY - APPLICANT COPY PINK - ASSESSORS COPY