29-362 (4) s
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of Nort4aniptou
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DEPARTMENT OF BUILDIXG INSPECTIONS
INSPECTOR 212 Main Street ' Municipal Building
Northampton, Mass. 01060
SOLID FUEL BURNING APPLIANCE & CHIMNEY APPLICATION
Page Plot _ zone LISA Permit Number 4q6
Location
Owner or Lessee o-^ v�"�O '� 6-7 Q-�
J (Tele. No.)
Contractor ..� 44.. 4,0
License Number
Address
RESIDENTIAL NON-RESIDENTIAL
One Family Home Business
Two or More Number of Units Other (Specify)
Floors in Bldg.
Type of Appliance:
i� New Wood Burning
Used _ Coal It
Labeled Combination
Date of purchase Furnace
Fireplace Insert
Model or Type of Appliance
Manufacturer
Purchased From
0
Add ess)
Cost - Construction A Appliance:
Chimney _ New Metal Bestos
D�EXIYVA1u- Interior Chimney
Separate Flue Exterior Chimney
Other appliance attached to f ue
VMasonary/lined
Unlined
Notes & Data:
Signature of Applicant:
Building Inspector Approval:
Date: C ?3
r
��K.
Dep*tment of Building Inspections
212 Main Street BUILDING Z°
.WxAhamp ton, Mass. 01060 0< lo - OD
PERMIT
29 - 362 VALIDATION
DATE May 19, 19 83 PERMIT NO. 240
APPLICANT Francis & Jo-Ann Pinard ADDRESS 219 Acrebrook Drive PTA
(N0.) (STREET) (CONTR'S LICENSE)
OF
PERMIT TO build Chimney (—) STORY One Family Hone DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
219 Acrebrook Drive 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 Shenadow (masonary/lined)
(TYPE)
REMARKS: peratit to build chimney (exterior)
AREA OR 650.00 PERMIT 10.00
VOLUME ESTIMATED COST $ _FEE
(CUBIC/SQUARE FEET)
fi
Francis & Jo-Ann Pinard
OWNER
Acrebrook rive BUIL
ADDRESS BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY PINK - SESSORS COPY